Cyclophosphamide-based combination therapies for autoimmunity.

Immunomodulatory agent (IMA)-unresponsive multiple sclerosis (MS) can quickly evolve to a dramatic and irreversible disability. Treating these patients with appropriate immunosuppressive therapies can be a chance to arrest disease activity and progression. Cyclophosphamide (Cyc)-based intense immunosuppression has been successfully used to treat rapidly deteriorating, IMA-refractory MS patients. Therapeutic protocols combining Cyc and interferon beta (IFNbeta) have also been successfully applied to treat IFNbeta-unresponsive MS. The association of Cyc with other immunomodulatory drugs or monoclonal antibodies is currently being investigated in clinical trials aimed at treating severe forms of autoimmune diseases.