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To the Editor:
Krapf et al. and the Mitoxantrone in Multiple Sclerosis study group (MIMS)1,2 describe a disappointing impact of mitoxantrone treatment on MRI gadolinium enhancing lesions. Coming from this highly respected group, this article is likely to be influential. The MIMS investigators have also distinguished themselves for their statistical sophistication yet the disparity between the data and the conclusions born of statistical analysis is dramatic. The authors should further clarify the statistical approach, which was not adequately detailed.
The authors concluded that at months 12 and 24, neither mitoxantrone 5 mg/m2 (M5) nor mitoxantrone 12 mg/m2 (M12) produced a statistically significant difference in the total number of scans exhibiting gadolinium enhancement (GE), relative to the placebo group. However, in the M12 group, 10 of 34 subjects had GE at baseline and 1/34 had GE …
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