A new study published in The Lancet reveals that a common cholesterol drug may help to slow disability in people with progressive forms of multiple sclerosis (MS).
A research team led by Dr. Jeremy Chataway, a neurologist at the National Hospital for Neurology and Neurosurgery in London, found that high, daily doses of simvastatin, (sold under the brand name Zocor), reduced brain atrophy in people with progressive MS.
Brain volume has been shown in earlier studies to be directly linked to disability.
What is encouraging to note, said Dr. Timothy Coetzee, Chief Advocacy, Services and Research Officer at the National MS Society in an interview with Healthline, “is that cholesterol lowering therapies may hold promise for treating people with secondary progressive MS, for whom there are currently few treatment options.”
The Study Design
Chataway's team divided 140 people ages 18 to 65 with secondary-progressive MS into two groups. One group received simvastatin for two years while the other group took a placebo. The study was double-blinded, meaning that neither the researchers nor the participants knew who was on simvastatin and who was taking placebo.
The participants had a yearly MRI scan to record the volume of their brains, as well as other tests including the EDSS, which is used to measure disability and progression in MS.
At the end of two years, researchers found that the group taking simvastatin showed 43 percent less brain atrophy than the placebo group. And the simvastatin group experienced no more adverse events than the placebo group, suggesting that the drug was well tolerated.
Simvastatin: History and Safety
According to the National Library of Medicine, simvastatin was first approved for use in the U.S. in 1991. Like all statin drugs, simvastatin lowers LDL, or “bad” cholesterol, and in turn decreases the risk of heart attack and stroke.
Two decades after its approval, simvastatin is still widely used to treat high cholesterol with “more than 40 million prescriptions being filled yearly.”
Simvastatin is considered to be safe with minimal side effects, which, according to MedlinePlus, can include constipation, nausea, headache, memory loss, and forgetfulness. Because there is also a slight risk of liver damage, people taking the drug should be monitored regularly.
Finally a Treatment for Progressive MS?
“We hope these are the first steps towards a treatment for secondary progressive MS,” Chataway told Healthline. Although it isn’t yet clear how statins prevent brain atrophy, Chataway theorizes, “perhaps they protect the blood vessels [or] endothelium.”
Why statins are effective for progressive MS but not relapsing MS remains a mystery that only further research can solve. The more scientists learn about MS, the more they think there may be two different disease processes at work in relapsing and progressive forms of the disease, one that involves the body's inflammatory immune response and another that does not.
Chataway cautions that this was a small, phase 2 study, so he doesn't recommend that people with progressive MS start to take simvastatin just yet. With these promising results, however, the next step will be to conduct a phase 3 study with 800 or more volunteers who have progressive MS. According to Chataway, large-scale studies will decide for certain how effective statins might be in treating this long neglected form of the disease.
“It’s also proof of concept that you can repurpose a therapy successful in treating one disorder and target it for the successful treatment of something totally different,” Coetzee said.
And because it’s already on the market as a generic cholesterol treatment, if simvastatin is approved for progressive MS, it is sure to be affordable. A 30-day supply sells at Costco stores for less than $6.00.