Cytoxan is an immunosuppressant medication that is given intravenously (into a vein) or orally. It works by binding to cell DNA and interfering with cell division and replication.
- Cytoxan is FDA-approved for the treatment of various types of cancers.
- It is used "off-label" to treat a number of autoimmune conditions such as granulomatosis, myasthenia gravis, lupus, rheumatoid arthritis and MS.
Several clinical trials in people with MS demonstrated a reduction in relapses, fewer new areas of CNS inflammation
and a variable effect on disease worsening.
Side effects and risks include nausea, vomiting, hair thinning/loss, low white blood cell count, risk of infections, risk of cancers, infertility, inflammation of the bladder with bleeding, and fetal abnormalities.
Imuran is an oral immunosuppressant drug that targets activation, proliferation, and differentiation of both T and B lymphocytes.
- Imuran is FDA-approved for use in combination with other medications to prevent organ rejection after kidney transplant and also for the treatment of active rheumatoid arthritis. It is used outside of FDA approval for conditions such as Crohn's disease, ulcerative colitis, lupus, autoimmune hepatitis, neuromyelitis optica, myasthenia gravis and MS.
Imuran has been used in MS for over 30 years. Several clinical trials of Imuran as a monotherapy (use of a single drug to treat a disease or condition) and in combinations with other DMTs have demonstrated an effect on relapse reduction, new CNS inflammation and disease worsening. Imuran is approved in parts of Europe for use in MS, but not in the US at this time.
Side effects and risks include abdominal pain, severe nausea, vomiting, loss of appetite, mouth sores/ulcers, increased risk of infection, hair loss, change in hair color and texture, risk of malignancies and blood abnormalities, and fetal abnormalities.