Antioxidant Lipoic Acid Reduces Brain Tissue Loss in Small Trial Involving People with Secondary-Progressive MS
July 11, 2017
- In a study of 51 people with secondary progressive MS, the antioxidant lipoic acid was shown to reduce the rate of brain tissue loss compared to placebo. Walking improved, but not significantly.
- Safety issues included stomach upset and two cases of kidney dysfunction.
- The researchers are planning a larger, phase 2 clinical trial to further evaluate whether lipoic acid is a safe and effective treatment for progressive MS.
- The team (Rebecca Spain, MD, MSPH, Oregon Health & Science University, and colleagues) report their findings in Neurology & Neuroinflammation, an open access journal (Published online June 28, 2017).
Antioxidants are natural or manmade substances found in many foods. In MS, the immune system damages and destroys myelin, the material that surrounds and protects nerve fibers in the brain and spinal cord. Nerve fibers themselves are damaged as well, which appears to drive long-term disability. “Free radicals” are normal by-products of bodily processes, and may cause tissue injury and turn on immune attacks in MS. Antioxidants block the action of free radicals. Controlled trials are underway to test the potential of several antioxidants for treating MS.
Drs. Rebecca Spain, Dennis Bourdette (Oregon Health & Science University) and colleagues randomly assigned 51 people with secondary progressive MS to receive lipoic acid (1,200 mg) or placebo by mouth daily for two years. The primary outcome was the change in percentage of brain volume as measured on MRI scans. Secondary measures included changes in disability and walking, quality of life, and safety.
The results showed that the rate of brain volume loss was reduced by 68% in the lipoic acid group compared to the placebo group. Brain volume loss is thought to be associated with MS disability; a reduction in the rate of brain volume loss may result in less disability. A test showed improvement in walking in the lipoic acid group, although this change did not reach statistical significance. The lipoic acid group also reported significantly fewer falls than the placebo group.
Adverse events in the lipoic acid group included stomach upset, along with one case of kidney failure and one case of kidney inflammation. The authors suggest close monitoring of kidney function in future studies of lipoic acid, and that caution should be exercised before recommending this dosage, since the kidney problems had not occurred in previous studies.
The team reports its findings in Neurology & Neuroinflammation
, an open access journal (Published online June 28, 2017
This team is planning a larger phase 2 study
at multiple medical centers to further evaluate whether lipoic acid is a safe and effective treatment for progressive MS. This study is not yet recruiting participants.
Read more about diet and nutrition in MS
Multiple sclerosis is an unpredictable disease of the central nervous system. Currently there is no cure. Symptoms vary from person to person and may include disabling fatigue, mobility challenges, cognitive changes, and vision issues. An estimated 1 million people live with MS in the United States. Early diagnosis and treatment are critical to minimize disability. Significant progress is being made to achieve a world free of MS.