Statins may provide doctors with an unlikely new weapon with which to slow the progression of multiple sclerosis (MS).
No treatments can currently abate the advanced stage of the disease, known as secondary progressive MS, which gradually causes patients to become more disabled.
In a two-year clinical trial involving 140 patients with secondary progressive MS, the drug simvastatin slowed brain shrinkage, which is thought to contribute to patients' impairments. Supporting this finding, patients on simvastatin achieved better scores on movement tests and questionnaires that assess disability than patients taking a placebo.
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 per cent of people with relapsing remitting MS develop secondary progressive MS within 15 years of being diagnosed. The secondary progressive phase is where MS has the most personal and societal costs.
The authors of the new study, which was led by Imperial College London, said the findings were very encouraging, but would need to be replicated in a larger trial. The work is published today in the Lancet.
"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. "Discovering that statins can help slow that deterioration is quite a surprise. This is a promising finding, particularly as statins are already cheap and widely used.
"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," he added.
Dr Nicholas ran the trial with Dr Jeremy Chataway, then in the Department of Medicine at Imperial and now at University College London.
Statins are taken by millions of people to lower cholesterol and prevent heart disease, but it's unclear why they would have a beneficial effect on MS.
Some small studies have found a small benefit from statins in relapsing remitting MS, which is more treatable.
Secondary progressive MS has proven more challenging to alleviate. In 2013, cannabis became the latest drug to prove unsuccessful at slowing the progression of MS in a clinical trial.
This clinical trial is the culmination of long-standing research led by Professor John Greenwood at the UCL Institute of Ophthalmology showing the potential therapeutic benefits of using statins to treat autoimmune diseases such as multiple sclerosis 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."
The study was funded by J.P Moulton Foundation, Berkeley Foundation, Multiple Sclerosis Trials Collaboration, Rosetrees Trust and the National Institute for Health Research (NIHR).
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Notes to editors
1. Reference: J. Chataway et al, 'Effect of high-dose simvastatin on brain atrophy and disability in secondary progressive multiple sclerosis (MS-STAT): a randomised, placebo-controlled, phase 2 trial', The Lancet 383 (2014), doi: 10.1016/S0140-6736(13)62242-4
2. About Imperial College London
Consistently rated amongst the world's best universities, Imperial College London is a science-based institution with a reputation for excellence in teaching and research that attracts 14,000 students and 6,000 staff of the highest international quality. Innovative research at the College explores the interface between science, medicine, engineering and business, delivering practical solutions that improve quality of life and the environment - underpinned by a dynamic enterprise culture.
Since its foundation in 1907, Imperial's contributions to society have included the discovery of penicillin, the development of holography and the foundations of fibre optics. This commitment to the application of research for the benefit of all continues today, with current focuses including interdisciplinary collaborations to improve global health, tackle climate change, develop sustainable sources of energy and address security challenges.
In 2007, Imperial College London and Imperial College Healthcare NHS Trust formed the UK's first Academic Health Science Centre. This unique partnership aims to improve the quality of life of patients and populations by taking new discoveries and translating them into new therapies as quickly as possible.
3. About the National Institute for Health Research
The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website.
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