Cholesterol Drugs Show Promise for MS

First human trial of statins requires confirmation

THURSDAY, May 13, 2004 (HealthDayNews) -- A pioneering study finds that a cholesterol-lowering statin drug can help people with multiple sclerosis.

It is a small, relatively short study that is merely a prelude to the larger, longer trials needed to establish the value of statins for multiple sclerosis, said Dr. Inderjit Singh, director of the division of developmental neurogenetics at the Medical University of South Carolina. He is the leader of the group reporting the results in the May 15 issue of The Lancet.

Nevertheless, Singh said, "this is the first human trial to indicate that statin therapy might be of value in treating multiple sclerosis."

The disease, which affects an estimated 200,000 Americans, is the result of an immune system attack against myelin, the tissue that provides a protective covering for nerve cells. Most MS patients experience periodic, unpredictable flare-ups as normal nerve function is disrupted.

In the trial, the 30 MS patients who took daily doses of a statin had a 44 percent reduction in brain lesions after three months of treatment, compared to the lesions identified before the treatment began.

"The next step is to do larger trials," said Dr. Patricia O'Looney, director of biomedical research programs at the National Multiple Sclerosis Society. "Some are already in the planning stage."

For example, researchers at the University of California at San Francisco are planning a trial of atorvastatin, marketed as Lipitor, she said. Singh's group used simvastatin, marketed as Zocor.

Any new drug for multiple sclerosis will be more than welcome, O'Looney said. A number of drugs have been approved, but they have limited effectiveness and must be injected, a major inconvenience. Statins are taken orally.

Their effect on multiple sclerosis appears to be independent of their cholesterol-lowering activity, Singh said. Laboratory work and animal studies indicate they lessen the immune system attack on myelin and reduce the inflammation that worsens flare-ups, he said.

A number of questions have to be answered, O'Looney said. One is whether the effects of different statin drugs differ.

"We also have to find out whether the medication is better than what we already have, and can you combine it with one of the already approved treatments to get an additive effect," she said.

MS patients should wait for the results of new trials before taking statins, O'Looney advised.

One reason is that people with multiple sclerosis generally have safe levels of cholesterol, she said. "You have to make sure that when you give a statin to someone with normal levels you do not do damage by lowering those levels," she said.

And laboratory studies have indicated that statins sometimes can increase inflammation, "which is not something you want to happen," O'Looney said.

More information

You can learn about MS and how it is treated from the National Institute of Neurological Diseases and Stroke or the National Multiple Sclerosis Society.

SOURCES: Inderjit Singh, M.D., director, division of developmental neurogenetics, Medical University of South Carolina, Charleston; Patricia O'Looney, M.D., director, biomedical research programs, National Multiple Sclerosis Society, New York City; May 15, 2004, The Lancet
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