Efficacy and tolerability of mitoxantrone for neuromyelitis optica spectrum disorder: A systematic review

• Published in: Journal of neuroimmunology Vol. 332; pp. 126 - 134
• Main Authors: Enriquez, Clare Angeli G., Espiritu, Adrian I., Pasco, Paul Matthew D.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.07.2019
• Subjects: Cardiomyopathies - chemically induced; Devic's disease; Disease Progression; Epidemiologic Studies; Humans; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Infections - etiology; Intercalating Agents - adverse effects; Intercalating Agents - therapeutic use; Leukemia, Myeloid, Acute - etiology; Leukopenia - chemically induced; Mitoxantrone; Mitoxantrone - adverse effects; Mitoxantrone - therapeutic use; Neuromyelitis Optica - drug therapy; Neuromyelitis optica spectrum disorder; Randomized Controlled Trials as Topic; Recurrence; Topoisomerase II Inhibitors - adverse effects; Topoisomerase II Inhibitors - therapeutic use; Treatment Outcome; Devic's disease; Mitoxantrone; Neuromyelitis optica spectrum disorder
• ISSN: 0165-5728; 1872-8421
• DOI: 10.1016/j.jneuroim.2019.04.007

The review assessed the efficacy and tolerability of mitoxantrone in patients with neuromyelitis optica spectrum disorder (NMOSD). Eight articles were reviewed with a total of 117 patients. Annualized relapse rate and progression of disability dramatically decreased post-treatment in most studies. Mitoxantrone was generally tolerated. Only one patient developed acute myeloid leukemia, which lead to septicemia and death. No serious cardiotoxicity was reported. Mitoxantrone may be effective in reducing the frequency of relapse and slowing down the progression of disability in patients with NMOSD. The risk of cardiotoxicity and leukemia detains it as a second-line agent for NMOSD. [Display omitted] •Mitoxantrone may be effective in reducing the frequency of relapse in NMOSD.•It also slows down the progression of disability in NMOSD.•It is generally safe and tolerable for patients with NMOSD.