LONG-TERM IMMUNOSUPPRESSION IN MULTIPLE-SCLEROSIS - A 15 YEARS STUDY WITH AZATHIOPRINE

  • 1 January 1984
    • journal article
    • research article
    • Vol. 140  (10) , 553-558
Abstract
Since 1967, 211 probable or definite multiple sclerosis (MS) patients have received azathioprine (100 mg daily) as primary immunosuppressive treatment. Treatment results are evaluated in 145 patients who have received prolonged (.gtoreq. 1 yr) continuous therapy and whose disability had been evaluated prospectively. The main characteristics of these patients are the following: male 45, female 100; mean age of onset of MS: 27 yr; mean duration of treatment and follow-up: 67 and 115 mo., respectively. Patients (48) were in the progressive phase of MS at the onset of treatment; 17 of these had a stable disability score during therapy; however, the number of stabilized patients decreased significantly with duration of treatment. Among 97 patients in the remittent phase of the disease, 22 had no further bout during treatment, 41 had bouts but had no increase in disability and 34 were aggravated; in 14 of these, secondary progression occured during therapy. Hematologic, cutaneous, digestive and infectious side-effects occurred but were always reversible. In the subgroup of 131 patients who had received no other immunosuppressive treatment than azathioprine and in whom information was obtained at the end of 1982, 10 cancers (all of them epitheliomas) were diagnosed. The frequency of malignancy in the patients followed for .gtoreq. 5 yr was 10%. Five patients died from cancer (4 of 6 deaths in the remittent group). These results are compared with those of the series. The use of azathioprine in MS should be restricted.