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

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.

Automated summary

This study aimed to evaluate calcium-phosphate parameters in SPMS patients treated with mitoxantrone. Most SPMS patients eligible for MTX therapy had vitamin D deficiency at baseline, but supplementation led to an increase in serum vitamin D levels. Following MTX treatment, a higher percentage of patients underwent surgical fracture repair compared to before, indicating the importance of monitoring and patient compliance during therapy.