Calcium-phosphate homeostasis in secondary progressive multiple sclerosis patients during mitoxantrone therapy

ABSTRACT

Objectives

To assess calcium-phosphate parameters in SPMS patients treated with mitoxantrone (MTX).

Methods

Thirty eight SPMS patients eligible for MTX therapy in the Department of Neurology in Zabrze, Poland were enrolled in a prospective study from March 2016 to November 2019. The parameters of serum calcium-phosphate metabolism and the neurological status according to the Expanded Disability Status Scale (EDSS) were assessed. In patients with hypovitaminosis D, vitamin D (VitD) supplementation was introduced (4000 IU/day for 1 month and later 2000 IU /day).

Results

Most patients were women [57.89%]. The mean age [years] was 56.11 (±7.74). The median time from diagnosis to inclusion day (ID) was 7.50 [4.00–14.00] [years]. Due to VitD supplementation, an increase in serum VitD was observed during the study. 84.21% of patients presented with hypovitaminosis D before MTX treatment compared to 47.37% after treatment. Before MTX therapy, none of the patients underwent surgical repair of the fracture compared to 42.11% of patients after MTX treatment (p < 0.01).

Discussion

Deficiency of VitD was observed at the baseline in most SPMS patients eligible for MTX therapy. Due to adverse reactions to MTX treatment, this therapy requires patient compliance, cautious drug administration and monitoring during the therapy.

KEYWORDS:

• Multiple sclerosis
• vitamin D
• supplementation
• mitoxantrone

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics approval

The protocol of the study was approved by the Ethics Committee of the Medical University of Silesia in Katowice, Poland (decision no. KNW/0022/KB1/130/I/12/15 of 24.02.2015).

Data availability

The data used to support the findings of this study have not been made available because they contain sensitive patient information.

Additional information

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Notes on contributors

Martyna Lis

Natalia Niedziela - Graduated from Medical University of Silesia. She works at Independent Public Clinical Hospital No. 1 for them. Prof. Stanisław Szyszko of Silesian Medical University in Katowice. She has published on neuroepidemiology, multiple sclerosis and stroke.

Natalia Niedziela

Maria Magdalena Nowak (-Kiczmer) - Graduated from Medical University of Silesia. She works at Independent Public Clinical Hospital No. 1 for them. Prof. Stanisław Szyszko of Silesian Medical University in Katowice.

Maria Nowak-Kiczmer

Martyna Lis - Graduated from Medical University of Silesia.

Katarzyna Kubicka-Bączyk

Monika Adamczyk-Sowa - Professor of Neurology at Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland. Chairman-elect of Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society.

Monika Adamczyk-Sowa

Katarzyna Kubicka-Bączyk – She works at Independent Public Clinical Hospital No. 1 for them. Prof. Stanisław Szyszko of Silesian Medical University in Katowice.