cholesterol RX & MS
Cholesterol drug cited in MS care
MUSC study finds decrease in brain lesions of patients
BY LYNNE LANGLEY
Of The Post and Courier Staff
A drug widely prescribed to lower cholesterol shows promise in treating the most common form of multiple sclerosis, according to a study directed and conducted in Charleston.
The study shows a significant decrease in the number and volume of active brain lesions of patients with the form of the degenerative disease in which symptoms come and go, it was announced Monday at the American Academy of Neurology annual meeting in Honolulu.
About 82 percent of the 28 people in the clinical trial had a decrease in active brain lesions within six months of taking simvastatin daily.
The trial that Dr. Lyndon Key, chairman of the Pediatrics Department at the Medical University of South Carolina, helped to design relied on MRIs to record brain lesions and showed a 40 percent reduction in brain lesions, a finding he describes as dramatic. A patient's symptoms aren't a reliable gauge because relapsing-remitting MS can cause temporary symptoms that wane only to reappear months or years later.
The oral statin drug is used safely by millions and costs less than a fifth the price of current MS medications that have to be injected and often cause side effects, Key noted.
MS, which involves paralysis and considerable pain, affects more than a quarter million Americans, said Dr. Charles P. Darby, MUSC chairman emeritus of pediatrics.
There has never been any MS treatment close to this good, Darby said."It is probably the treatment that medicine is going to adopt as the standard of care," he said, because it can be taken as pills, has no side effects and is affordable.
More and larger studies are needed, both doctors said. One study has started, and MUSC hopes to begin another in a couple of months, said Key, adding that it probably will take two years or longer for the federal Food and Drug Administration to approve simvastatin for MS treatment.
Meanwhile, Key and Darby foresee what's known as "off-label" use, in which doctors prescribe a drug that has proven safe and that FDA has approved for another use.
"The FDA does tolerate off-label use," Darby said.
"The faster the information is disseminated and the medicine is prescribed, the better the population will be," he said.
Key said the medication is so safe, he'd be surprised if it isn't prescribed for MS almost immediately. Patients in the study took 80 milligrams a day, two to four times the usual dose to lower cholesterol.
Some patients who are close to relying on wheelchairs for mobility will improve a great deal, Darby expects. He cautioned, however, that "we do not know how much people will improve."
"If a person already is crippled, they should not think they are going to walk again," Darby said.
Simvastatin may slow or prevent the progression of relapsing-remitting MS but would not repair destroyed nerve tissue, he noted.
Dr. Inderjit Singh, distinguished professor of pediatrics at MUSC, began working with statins to treat another illness and discovered the drugs dramatically reduced brain-damaging inflammation in cells and in rats.
Now, Singh said, "It is a most gratifying experience for me, as a basic science researcher, to see five years of tedious animal and cell research evolve into a potential treatment for a disease afflicting more than 2.5 million people worldwide."
What Singh found suggests statins also may combat other inflammatory conditions, including stroke, Alzheimer's and Parkinson's diseases, Key said, and Singh already has promising results in animals that had strokes.
"Hopefully this is the tip of the iceberg," Key said.
Yale University and the University of Colorado also participated in the MUSC-directed clinical trial, which will be presented formally at the neurology meeting today.
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