A recent study has revealed a glimmer of hope in the battle against progressive multiple sclerosis, but it's a complex story with mixed results. The potential of lipoic acid, a common supplement, has been under the microscope, and the findings might just change the way we approach this debilitating disease.
Led by Oregon Health & Science University and the Portland VA Health Care System, the research focused on the effects of lipoic acid on individuals with progressive MS. The results? Well, it's a bit of a rollercoaster. While the supplement showed some promise in slowing down the loss of gray matter in the brain, it fell short when it came to the primary clinical outcome: walking speed.
The study involved 54 participants with primary and secondary progressive MS, who took a daily dose of 1,200 milligrams of lipoic acid for two years. Researchers compared their progress to a control group of 61 individuals given a placebo. Besides walking speed, they also measured brain atrophy using MRI scans, other clinical outcomes, and safety.
Dr. Rebecca Spain, the lead author and an associate professor of neurology at OHSU, shared her insights: "It didn't deliver the clinical results we hoped for in progressive MS. But the reduction in brain atrophy seen on MRI scans suggests we might be onto something, especially if we can find a more effective way to deliver the antioxidant benefits of lipoic acid."
Multiple sclerosis is a condition where the protective myelin sheath covering nerve fibers in the central nervous system becomes damaged. This damage slows or blocks electrical signals, impacting our ability to see, move, feel, and think.
Researchers believe lipoic acid could have anti-inflammatory and antioxidant effects, potentially protecting damaged myelin and nerves. However, there's a catch: lipoic acid is lipophobic, meaning it struggles to cross the blood-brain barrier and reach the central nervous system.
The study built upon previous research, including a mouse model, dose-finding studies, and a promising pilot study from 2017. But the high dosage of lipoic acid used in the trial came with potential side effects. In fact, the OHSU study was paused at one point due to two participants developing a kidney condition linked to lipoic acid and other medications.
Despite these challenges, researchers remain optimistic. The findings have already inspired a larger research project in the UK called Optimal Clinical Trials Platform for Multiple Sclerosis (Octopus). This multi-arm, multi-stage trial will test lipoic acid and metformin against a placebo in a much larger participant group, combining OHSU's findings with other large datasets.
Dr. Spain, who is advising the UK initiative, said, "Together with the Octopus trial, we'll gain a clearer picture of whether lipoic acid is a worthwhile treatment for progressive MS. I'm cautiously optimistic about the potential."
