Statins may provide doctors with an unlikely new weapon with
which to slow the progression of multiple sclerosis (MS).
No treatments can currently abate the advanced stage of the
disease, known as secondary progressive MS, which gradually causes
patients to become more disabled.
In a two-year clinical trial involving 140 patients with
secondary progressive MS, the drug simvastatin slowed brain
shrinkage, which is thought to contribute to patients' impairments.
Supporting this finding, patients on simvastatin achieved better
scores on movement tests and questionnaires that assess disability
than patients taking a placebo.
MS is a neurological condition that affects around 2.3 million
people worldwide. Most patients are initially diagnosed with
relapsing-remitting MS, which causes periodic attacks. Around 65
per cent of people with relapsing remitting MS develop secondary
progressive MS within 15 years of being diagnosed. The secondary
progressive phase is where MS has the most personal and societal
costs.
The authors of the new study, which was led by Imperial College
London, said the findings were very encouraging, but would need to
be replicated in a larger trial.
"At the moment, we don't have anything that can stop patients
from becoming more disabled once MS reaches the progressive phase,"
said Dr Richard Nicholas from the Department of Medicine at
Imperial. "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.
"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," he added.
Dr Nicholas ran the trial with Dr Jeremy Chataway, then in the
Department of Medicine at Imperial and now at University College
London.
Statins are taken by millions of people to lower cholesterol and
prevent heart disease, but it's unclear why they would have a
beneficial effect on MS.
Some small studies have found a small benefit from statins in
relapsing remitting MS, which is more treatable.
Secondary progressive MS has proven more challenging to
alleviate. In 2013, cannabis became the latest drug to prove
unsuccessful at slowing the progression of MS in a clinical
trial.
This clinical trial is the culmination of long-standing research
led by Professor John Greenwood at the UCL Institute of
Ophthalmology showing the potential therapeutic benefits of using
statins to treat autoimmune diseases such as multiple sclerosis and
uveitis.
Professor Greenwood said, "After nearly two decades of research,
it is immensely gratifying to see this work progress into the
clinic to deliver benefits to patients."
The study was funded by J.P Moulton Foundation, Berkeley
Foundation, Multiple Sclerosis Trials Collaboration, Rosetrees
Trust and the National Institute for Health Research (NIHR).
The paper, Effect of high-dose simvastatin on brain atrophy and disability in
secondary progressive multiple sclerosis (MS-STAT): a randomised,
placebo-controlled, phase 2 trial, is published in The
Lancet.