Mitoxantrone for multiple sclerosis in clinical practice.

Patients with worsening relapsing-remitting multiple sclerosis (MS), secondary progressive MS, and progressive relapsing MS are potential candidates for treatment with mitoxantrone. Early identification of these patients is essential because there is emerging evidence that early and aggressive treatment might delay or limit long-term disability. Treatment with mitoxantrone is associated with certain adverse events, such as cardiotoxicity. However, the possible benefits of treatment (e.g., reduction in disease progression) outweigh the risks for patients with aggressive or worsening disease. With the selection of appropriate patients and careful monitoring for adverse events, mitoxantrone can be safely administered.