Statins slow the progression of advanced MS

A study led by Imperial College London has found that statins may provide doctors with a way to slow the progression of multiple sclerosis (MS). Their results have been published in The Lancet.

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% of these develop secondary progressive MS within 15 years of being diagnosed.

“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, co-author of the study from the Department of Medicine at Imperial College London.

In a two-year clinical trial involving 140 patients with secondary progressive MS, participants were randomly assigned either the drug simvastatin or a placebo. Used by millions of people to lower cholesterol and prevent heart disease, simvastatin also has a good safety profile as well as immunomodulatory and neuroprotective properties, noted the researchers.

During the trial, simvastatin slowed brain shrinkage, which is thought to contribute to patients’ impairments. Those taking simvastatin achieved better scores on movement tests and questionnaires that assess disability than patients taking a placebo. The drug was also well tolerated, said the researchers, “with no differences between the placebo and simvastatin groups in proportions of participants who had serious adverse events”.

“Discovering that statins can help slow that deterioration is quite a surprise,” said Dr Nicholas, who noted that the statins are “already cheap and widely used”. Some small studies have found a small benefit from statins in relapsing remitting MS, but secondary progressive MS has proven more challenging to alleviate.

The clinical trial is the culmination of longstanding research, led by Professor John Greenwood at the UCL (University College London) Institute of Ophthalmology, showing the potential therapeutic benefits of using statins to treat autoimmune diseases such as MS 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.”

Dr Nicholas concluded, “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.”

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