Statins Show Early Promise for Treating Multiple Sclerosis

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Statins Show Early Promise for Treating Multiple Sclerosis

MULTIPLE SCLEROSIS STATINS CHOLESTEROL-LOWERING DRUGS

Description

Results of a preliminary study suggest that statins (cholesterol-lowering

drugs) could have potential in the treatment of multiple sclerosis (MS).

Issue 15 May 2004

(pp 1570, 1607)

Lancet 2004; 363: 1570, 1607-08 Results of a preliminary study in this

week's issue of THE LANCET suggest that statins (cholesterol-lowering drugs)

could have potential in the treatment of multiple sclerosis (MS).

Drug treatments for MS are expensive and only partially effective. Recent

knowledge that statins promote an anti-inflammatory response from the immune

system suggest a potential in the treatment of MS.

Inderjit Singh from the Medical University of South Carolina, USA, and

colleagues report how 30 people with MS given 80 mg simvastatin daily for 6

months had a 44% reduction in the proportion of brain lesions after three

months of treatment compared with lesions identified before treatment

initiation.

Dr Singh comments: " These findings suggest that an 80 mg daily dose of oral

simvastatin over a 6 month period could inhibit the inflammatory components

of multiple sclerosis that lead to neurological disability...Our results,

combined with the published work on the immunological effects of statins

lend support to the case for randomised controlled clinical trials to

establish the safety and efficacy of statins in the treatment of

relapsing-remitting multiple sclerosis " .

In an accompanying Commentary (p 1570), Polman from VU Medical Centre,

Amsterdam, Netherlands, concludes: " ...[this] study is a big step forward

because it is the first to provide some evidence of an effect with a statin

in multiple sclerosis-but it is only an initial step. Additional data are

required to more precisely determine the clinical effects of statins, to

explore the optimum dose, the therapeutic window, and the differential

potency of statins, and to evaluate whether combination therapy might be

more effective than monotherapy. Physicians, scientists, drug companies, and

regulatory agencies should now work together to design and do randomised

studies that have adequate power to address these and other important

issues. It is the joint responsibility of all involved to ensure that some

of the potential charms of statins (low-hurdle access, convenience, low

cost) do not develop into a dangerous boomerang, in case proper studies

become jeopardised by widespread off-label use " .

The potential for statins as treatment for MS is also discussed in a review

in the June issue of THE LANCET NEUROLOGY (page 369-71). Author Hans-

Hartung comments: " The obvious advantage of statins over existing MS

therapies is their oral route of dosing. Statins might be beneficial for MS

patients as monotherapy or as an add-on to established disease modifying

drugs. As the evidence of the benefit of statins in MS is currently

insufficient, large controlled clinical trials are needed. The first of

these trials is about to start " .