Cyclophosphamide for MS

Cyclophosphamide (the generic name for Endoxan, Cytoxan, Neosar, Procytox, and Revimmune) is used as a treatment for MS, but more commonly used for cancer treament alongside chemotherapy.

 

Method of Delivery:  Oral, injection or intravenous infusion

Cyclophosphamide is a very potent immunosuppressant, frequently used alongside chemotherapy in treatment regimens to treat leukaemia and other cancers.  It binds to DNA and prevents cells from dividing. When used to treat MS, it appears to act by reducing the numbers of B and T cells (types of white blood cell) that are involved in the immune attack of the myelin sheath.

Cyclophosphamide side effects when used to treat MS 

Cyclophosphamide has never been widely used in MS, but rather reserved for those people who have failed to respond to other treatments and have very active MS with rapid progression.  Research to date has shown only limited benefit, and the side effects can be very severe and often restrict its use.

  • Hair loss

  • Nausea and vomiting

  • Sub-fertility/ premature menopause

  • Bladder irritation

  • Gum pain

  • Risk of infections

There are concerns that long-term treatment with cyclophosphamide may increase the risk of some cancers.

You should not get pregnant or breastfeed whilst taking cyclophosphamide, as there are potential risks to the unborn baby.  

Revimmune is a short-course intravenous infusion of cyclophosphamide developed to treat a range of autoimmune conditions.  It may be an option for those with MS that is not responding to other treatments, but more research is required.

Page last updated 01 August 2019 


 

References:

  1. Brochet, B., Deloire, M. S. A., Perez, P., Loock, T., Baschet, L., Debouverie, M., . . . PROMESS, s. i. (2017). Double-blind controlled randomized trial of cyclophosphamide versus methylprednisolone in secondary progressive multiple sclerosis. PLoS One, 12(1) doi:http://dx.doi.org.hsclib-ezp.qub.ac.uk/10.1371/journal.pone.0168834
  2. Vahid Shaygannezhad, Hassan Amini. Comparing the Efficacy of Monthly Cyclophosphamide as Monotherapy versus Daily Fingolimod in Relapsing Remitting and Secondary Progressive Multiple Sclerosis. مجله دانشکده پزشکی اصفهان. 2017;(435):719. http://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=edsdoj&AN=edsdoj.1e7cd26d165f4d57b5b02c38afe78b57&site=eds-live&scope=site. 
  3. https://www.medpagetoday.org/neurology/multiplesclerosis/67263?vpass=1