Stopping Brain shrinkage, new research on statins in MS, MS Trust Annual conference 2013

mstrust annual conference 2013I’m Warwickshire at the MS Trust annual conference! Most impactful new learning so far?

Ok, soon to be published research by Jeremy Chattaway on the use of statins in progressive MS to reduce brain shrinkage.Everybody’s brain shrinks! by 0.2% a year. But for people with MS, the average is 0.6% a year.

This was a phase II trial of Simvastatin, a commonly used drug fro cholesterol ( that’s right, it reduces fat in the bloodstream). It also has ‘profound immunological effects’ and can cross the blood brain barrier ( ie get into the brain)

10-12 years ago this was trialled in relapsing remitting MS, but did not become an accepted treatment. Because secondary progressive MS also has features of inflammation, though in a more slow burning sort of way, it was decided to trial it, at 80mg daily. That’s a high dose, double what a lot of people with high cholesterol might take.

140 people were randomised to take this or a placebo. after 7 years, brain shrinkage in the group taking the drug had halved to 0.3% ( almost the normal rate).

Now I really hate putting my hand up to ask questions at these dos, because it’s really scary, you have to use a mike, everyone looks at you, and some neurologists are very dismissive and make you feel like an idiot in front of all your peers…. but I had to ask

” Do you have any idea what the mode of action is for simvastatin, and is it associated with reduction in saturated fat in the bloodstream, or not?”

With great releif, that was replied with ” Very good question!” .. and the answer that they really don’t know. Could it be “microvascular? a protective effect? or to do with cholesterol? All of this is discussed in the paper, which will be out soon!”

Phew. I hope someone will appreciate my sweat and blushes.

Also in Dr. Chattaway’s presentation was the new research recruiting now for people with 2ndary progressive MS, which I already shared in the post on MS Smart.

Additional understanding for me was the process they did of trawling 30,000 existing drugs that could possibly have form in protecting brain volume or nerves, to come up with the 3 most promising –

  1. Ibudolast, a Japanese asthma drug, which reduced the rate of brain atrophy in people taking it for asthma
  2. Riluzole – a drug that people with Motor Neurone Disease have already been taking for some years which showed that it reduced shrinkage of the spinal cord ( showing that it reduced loss of neurones, and
  3. Amiloride – a well known blood pressure drug in the UK, which blocks calcium channels in the brain, and reduces brain shrinkage.

People who enlist in the research to find out if any of these agents can protect the brain from axonal ( neuronal) loss, and thereby slow or halt progression, will be put on either one of these drugs, or a placebo ( dummy drug) for 2 years, and followed up with the usual clinical assessments, plus about 3 MRIs. There will be centres all over the UK so that you don’t have to travel too far.

Right. Now I’m off to get ready for the fancy dress gala dinner, subject, favourite childhood character. anyone else remember Pippi Longstocking? And later, i will be able to have a bath, with Nobody interrupting me!! More info, plus Photos( but not of the bath) later!

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