March 19, 2014
Statins May Be Effective In Treating Secondary Progressive Multiple Sclerosis
Brett Smith for redOrbit.com - Your Universe Online
At first, multiple sclerosis is recognized by sporadic neurological symptoms – a condition called relapsing-remitting MS. Within a decade or so, greater than 50 percent of patients acquire secondary progressive MS, a continuous deterioration of symptoms and boost in disability. Currently, there are no approved drugs for treating this later stage of the disease.However, a newly published study in the UK medical journal The Lancet has shown surprising evidence of a promising treatment for this second phase of MS – cholesterol-lowering statins.
"At the moment, we don't have anything that can stop patients from becoming more disabled once MS reaches the progressive phase," said study author Dr. Richard Nicholas, from the Department of Medicine at Imperial College London. "Discovering that statins can help slow that deterioration is quite a surprise. This is a promising finding, particularly as statins are already cheap and widely used.”
Previous studies have shown statins to have an anti-inflammatory and protective effect on the nervous system. A preliminary clinical study of simvastatin in individuals with early-stage MS revealed fewer brain lesions, indicating an impact on the underlying disease process. However, following trials have had inconsistent results.
In the new study, the researchers arbitrarily assigned 140 people with supplementary progressive MS, between the ages of 18 and 65 years old, to get either an 80-mg dose of simvastatin or placebo for two years.
"In the progressive stage of MS the brain shrinks by about 0.6% a year. Our main measure of success was to reduce the rate of brain atrophy,” said study leader Dr. Jeremy Chataway, a neurologist at University College London Hospitals.
Evaluation of pre-treatment and post-treatment MRI brain scans revealed a decrease in the average atrophy rate – to 0.3 percent a year with simvastatin, which is a 43 percent reduction compared to placebo after adjusting for confounding factors. Furthermore, small but noteworthy improvements were found in both a doctor- and patient-reported disability scale, the researchers said. Simvastatin was normally well-tolerated and significant negative events were comparable between the two groups – 20 percent with placebo versus 13 percent with simvastatin.
"Caution should be taken regarding over-interpretation of our brain imaging findings, because these might not necessarily translate into clinical benefit,” Chataway said. “However, our promising results warrant further investigation in larger phase 3 disability-driven trials."
"We need to do a bigger study with more patients, possibly starting in the earlier phase of the disease, to fully establish how effective it is," added Nicholas.
While smaller past studies have found a small benefit from using statins to treat relapsing remitting MS, secondary progressive MS has proven more challenging to treat.
In commenting on the new study, Jacqueline Palace from the John Radcliffe Hospital in Oxford, UK and Neil Robertson from Cardiff University in Wales said, "Chataway and colleagues' study is a promising and novel development.”
“Further phase 3 studies to measure the effect of simvastatin on sustained disability, particularly in patients with non-relapsing secondary progressive and primary progressive multiple sclerosis, are clearly needed, but this trial represents a promising point from which to develop trials of progressive disease,” they added.