Pixantrone (BBR2778): a new immunosuppressant in multiple sclerosis with a low cardiotoxicity

Abstract

Mitoxantrone (MX) has been approved by the Food and Drug Administration for the treatment of rapidly progressive multiple sclerosis (MS). Unfortunately, its long-term administration is prevented by the cardiotoxicity. Pixantrone (PIX) is an analogue of MX devoid of toxic effects on cardiac tissue and was developed as a replacement for other anthracenediones in cancer patients. With a view to an application in MS patients, experimental data demonstrated that PIX is as potent as MX in preventing acute experimental allergic encephalomyelitis development as well as the occurrence of relapses in the chronic model. Safety data from animal studies and from phase II trials in cancer patients confirm a very weak cardiotoxicity, if any. A phase I trial with PIX in patients with a rapidly progressive MS seems thus warranted.