Secondary Progressive Multiple Sclerosis & Statins

There has been a lot of media attention recently on a trial testing statins as a treatment for multiple sclerosis (MS).  The study is being led by University College London and will involve over 1100 people with secondary progressive MS (SPMS) across the United Kingdom.

Statins are a group of drugs that are designed to reduce levels of bad cholesterol (low-density lipoprotein or LDL) in the blood. You may remember that we recently published a summary of a collaborative Australian research project that showed that adverse levels of lipids or fats in the blood was associated with higher rates of relapses and worse disease progression.  You can read that summary here.  This provides an indication as to why statins could be a useful new treatment approach for multiple sclerosis.

A number of studies have been performed with statins in animal models of multiple sclerosis (EAE).  These experiments have shown that statins can have an anti-inflammatory effect and also decrease the numbers of immune cells getting into the central nervous system (CNS).  The combination of these outcomes led to an improvement of clinical signs in the disease model.

However, it is important to realise that this is not the first trial of statins in people with multiple sclerosis.  A number of small studies have investigated the use of different forms of statins in people with relapsing-remitting multiple sclerosis (RRMS).  In most of these trials, there hasn’t been a strong significant benefit observed, especially when statins have been used as the sole treatment.

The most encouraging result has come from a small trial that looked at simvastatin in people with SPMS.  The findings from this trial suggested that the statin treatment could have a moderate impact to slow brain atrophy and disease progression.

It is this result in SPMS that will form the basis for the new trial that is currently being reported, which is expected to take around 6 years to complete.  It is important to realise that part of this study will also be looking at the safety of the statin treatment.  Whilst statins are generally well tolerated, this trial will be using them at a higher dose – the long term effects of which are currently unknown.  The study is being funded by the MS Society UK, the National Institute for Health Research, the US National MS Society, the NHS and a number of UK universities.

You can find more information about this trial on the MS Society UK website both here and here.  The thoughts of the Neuroimmunology team at Barts and The London School of Medicine and Dentistry can also be read here.