Progressive Multiple Sclerosis Responds to Biotin
High doses of biotin, which is also known as vitamin H, were associated with improvements in disability among patients with progressive multiple sclerosis. The results of this latest study, which follows on the heels of another research endeavor concerning biotin for multiple sclerosis, will be presented at the American Academy of Neurology annual meeting on April 24, 2015.
The phase III placebo-controlled trial involved 154 patients with progressive multiple sclerosis who were given either 300 mg per day of biotin (as the drug MD1003) or placebo for 48 weeks. The usual recommended daily dose of biotin is 30 to 100 micrograms (mcg) daily.
All the participants were evaluated at 9 months and 12 months. Improvement was defined as either a decline in the Expanded Disability Status Scale (EDSS) of at least 1 point for patients who had a baseline EDSS of 5.5 or less and 0.5 points for those with an EDSS of 6 or greater, or who showed an improvement of 20 percent or more on a timed 25-foot walk.
Why biotin? This vitamin is a coenzyme for carboxylases, enzymes that play a critical role in energy metabolism and the production of fatty acids. In particular, biotin activates acetylCoA carboxylase, which is involved in the synthesis of myelin.
Therefore, it is proposed that biotin may help to slow, stop, or even reverse the progression of disability associated with demyelination. Demyelination is the loss of the myelin that protects the nerves and thus results in progressive loss of function.
According to a release from MedDay Pharmaceuticals, which makes the high-dose biotin drug, the result “suggests that MD1003 could be an important and efficacious treatment for primary and secondary progressive multiple sclerosis,” according to Professor Ayman Tourbah, of CHU de Reims, Neurology, France, and the principal investigator of the study.
Previous biotin and multiple sclerosis study
A small uncontrolled pilot study (23 patients) administered 100 to 600 mg (mean, 300 mg) per day of biotin to patients with primary or secondary progressive multiple sclerosis. The patients were treated for a mean of 9.2 months (range, 2-36).
Here are the findings:
- 4 patients who had prominent visual impairment associated with optic nerve injury experienced significant improvement in visual acuity
- 1 patient with left homonymous hemianopia (blindness in more than 50% of field of vision) continued to improve from 2 to 16 months after treatment started
- 16 of 18 (89%) patients with prominent spinal cord involvement improved, which was confirmed with blinded review of videotaped exam of 9 patients
- The following signs and symptoms improved for the number of patients (in parentheses): fatigue (5), swallowing problems (4), unclear articulation of speech (dysarthria, 3), sensory signs (2), gait problems (2), urinary dysfunction (2), cognition (1), psychiatric signs (1), visual problem (oscillopia, 1), motor coordination (1), and Uhthoff’s phenomenon (1)
- EDSS scores improved significantly in 22 percent of patients
(By way of disclosure, it should be noted that the CEO of MedDay, Frederic Sedel, MD, participated in the biotin research for multiple sclerosis reported here.)
Biotin has not been shown to be toxic. Doses up to 200,000 mcg/day (equal to 200 mg) have been tolerated in people who have hereditary disorders of biotin metabolism. In healthy individuals, doses of up to 5,000 mcg/day (5 mg) taken for two years resulted in no adverse effects.
Biotin is a new entry into the arena of potential treatment options for multiple sclerosis. Currently there are at least two clinical trials exploring the effects of biotin (MD1003) in multiple sclerosis.
Linus Pauling Institute
Sedel F et al. High doses of biotin in chronic progressive multiple sclerosis: a pilot study. Multiple Sclerosis and Related Disorders 2015 Mar; 4(2): 159-69