Effect of monthly intravenous cyclophosphamide in rapidly deteriorating multiple sclerosis patients resistant to conventional therapy

Fourteen consecutive clinically definite relapsing-remitting multiple scler osis (MS) patients were treated with monthly intravenous cyclophosphamide ( CTX) for 6 months. All had experienced severe clinical deterioration during the 12 months prior to treatment with CTX despite treatment with conventio nal immunomodulating agents and intravenous methylprednisolone. Treatment w ith CTX led to improvement and neurologic stability within 6 months which w as sustained for at least 18 months after the onset of treatment with CTX. Therapy with CTX was well tolerated. CTX may be of benefit in MS patients w ho experience rapid clinical worsening and ore resistant to conventional th erapy.