Statin keeps MS patients s'myelin

Simvastatin may undermine interferon as the gold standard in MS treatment

By Williams D Donaldson

There may be a silver lining to air traffic controller Peter Allyson's multiple health troubles. Besides having high cholesterol, Peter, 42, suffers from multiple sclerosis (MS). Surprisingly though, the statins that Peter uses to manage his cholesterol could open a new front in the war by battling his MS as well. Findings published in the May 15 issue of The Lancet, reveal a dramatic reduction in the number of identified brain lesions in MS patients after treatment with simvastatin.

Dr Inderjit Singh from the Medical University of South Carolina and colleagues gave 30 MS patients 80mg of simvastatin daily for six months. They then compared the number of lesions as seen on MRI before treatment with the number of lesions after four, five and six months of treatment. The number of lesions was found to be 44% less and their total volume was reduced to 41% of pre-treatment levels.

Dr Singh comments: "These findings suggest that an 80mg daily dose of oral simvastatin over a six-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 randomized controlled clinical trials to establish the safety and efficacy of statins in the treatment of relapsing/remitting multiple sclerosis."

Implementing this treatment in MS, however, does dredge up some concerns. For one thing, statins have never been adequately tested in people with normal cholesterol levels. Dr Timothy Vollmer, one of the authors, acknowledged these concerns, but said: "When used in patients with normal cholesterol, this drug does not appear to reduce levels any further. And with the large number of people using the drug longterm for the treatment of cholesterol, the overall safety profile seems good."

"What's really exciting about this treatment is that it targets only that area of the immune system that is directly related to MS. So, you don't get the kind of overall immune suppression you might have with other treatments," explains Dr Vollmer. Simvastatin isn't free of side effects but its negative effect on the immune system is far more limited than interferon, the current gold standard in relapsing/remitting MS.

In June's issue of The Lancet Neurology, Dr Hans-Peter Hartung discusses some other advantages of statins: "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." For MS sufferers, these trials offer hope that a new treatment with fewer side effects will soon be available.