Statins for Multiple Sclerosis
A new meta-analysis and review of statins for multiple sclerosis has just been published, and it seemed like a good opportunity to take a look at what scientists say about statins for MS. It also would be enlightening to hear from people with multiple sclerosis concerning their experiences and opinions about using these drugs.
Statins (e.g., atorvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin) are approved by the Food and Drug Administration (FDA) for lowering cholesterol levels. These drugs can accomplish this by inhibiting the enzyme HMG-CoA reductase, which is instrumental in the production of cholesterol in the liver.
Statins are controversial drugs for several reasons. One is the apparent push to expand the user population by recommending the drugs for otherwise healthy individuals who are at increased risk for heart disease. Another reason is the side effects associated with use, including muscle pain, abnormal liver enzyme tests, higher risk of diabetes, and muscle damage.
Statins for multiple sclerosis
Some research has suggested that statins may help with multiple sclerosis because they possess neurotrophic and immune system benefits.
A new systematic review and meta-analysis of eight trials has been published, and the eligible studies included five in which statins were used along with interferon in remitting-relapsing MS and one each of statins only for clinically isolated syndrome (CIS), optic neuritis, and secondary progressive MS. The meta-analysis was done on the five trials only, however.
The investigators observed the following trends associated with statin use in the five studies:
- An increase in the proportion of patients with relapse
- An increase in disease activity associated with new T2 lesions
- An increase in whole brain atrophy
Regarding the remaining three studies, the authors noted the following:
- A significant reduction in progression of disability and in brain atrophy in the secondary progressive multiple sclerosis study but no impact on relapse rate
- No effect on relapse activity, risk of multiple sclerosis, or MRI (magnetic resonance imaging) activity in the CIS study
- An improvement in visual outcome but no differences in risk of MS, MRI activity, or relapse activity in the optic neuritis group
In an Italian report from 2014, the authors pointed out that previous research has indicated that statins have potential neuroprotective and anti-inflammatory properties, which makes them attractive for treating multiple sclerosis. However, “the attempt to translate the results of animal model studies in humans produced conflicting results.” This suggests it is much too soon to give a green light for statins use among MSers.
Side effect concerns
In a survey of more than 10,000 adults, Experts evaluated the beliefs, attitudes, and behaviors of more than 10,000 adults in the United States who were current users (88%) or former users (12%) of statins. They found that
- Nearly one third (29%) of all the participants reported muscle weakness or pain
- 60% of former users and 25% of current users had muscle-related side effects
- The main reason the 1,220 former users stopped taking statins was because of side effects (62%) followed by cost (17%) and ineffectiveness (12%)
This review and meta-analysis suggests that statins may be helpful for individuals who have secondary progressive multiple sclerosis but that they cannot be recommended for people with remitting-relapsing MS, CIS, or optic neuritis.
What has been your experience with statins? If you have secondary progressive multiple sclerosis, are you taking or would you consider taking statins?
Also read about alternative treatments for MS
Ciurleo R et al. Role of statins in the treatment of multiple sclerosis. Pharmacological Research 2014 Sep; 87:133-43
Pihl-Jensen G et al. Statin treatment in multiple sclerosis: a systematic review and meta-analysis. CNS Drugs 2015 Mar 15