Lipoic Acid May Limit Brain Atrophy in SPMS Patients

Antioxidant liopic acid reported efficacy in treating secondary progressive multiple sclerosis cases.

A new pilot study has sparked hope that a common over-the-counter therapy might be able to slow brain atrophy in patients with secondary progressive multiple sclerosis (SPMS).

Researchers from the Oregon Health and Science University reported positive results when they gave high doses of the antioxidant lipoic acid (LA) to patients with SPMS. If the results are confirmed in a larger study, the finding could be a significant advance in the treatment of SPMS, an area of MS research where breakthrough treatments have been fewer and farther between.

Overall, the study found patients who took the LA supplement saw a 68% reduction in percent change in brain volume (PCBV), a measure of brain atrophy. MS patients with higher levels of brain atrophy are at a higher risk of physical and cognitive decline.

“This two-year pilot trial of 1,200 mg daily LA demonstrated significant reduction in PCBV in patients with SPMS over controls,” the authors wrote. “The small sample size precluded detection of clinical benefits, although there was suggestion of improved walking times and significantly fewer falls.”

The study consisted of 51 patients, and was conducted between 2011 and 2015. Twenty-seven patients were given daily doses of LA; the other 24 patients were given a placebo. Each patient was tracked for 2 years.

The therapy proved safe and rates of compliance was high. Adverse events were limited, and the study’s lead author, Rebecca Spain, MD, MSPH, noted that the resulting reduction in brain atrophy compared favorably with the 17.5% improvement shown in a 2015 phase 3 trial of ocrelizumab.

However, there are several key differences between the ocrelizumab study and this LA pilot study: the ocrelizumab study was much larger, tracked patients for 120 weeks, and included only primary progressive MS (PPMS) patients.

Though this pilot can’t compare with the large Phase III, Spain said the findings from the pilot make clear that more study of LA is warranted.

“These are high doses,” Spain said. “And while it seems safe, we won’t know whether it actually improves the lives of people with MS until we can replicate the results in the pilot study through a much bigger clinical trial. Fortunately, we’re going to be able to answer that question with the participation of kind volunteers.”

The next step for Spain and her colleagues will be a larger multi-site clinical trial to begin later this year.

The larger study will also allow researchers to refine one facet of their study that might have played a role in influencing the findings. After the study was begun, researchers found out that the placebo given to patients included quercetin, a bioflavonoid that some researchers have linked with increased inflammation. It is therefore possible that the placebo might have increased inflammation in the control group patients, thus skewing the brain atrophy results.

That potential confounder can be weeded out in a larger trial, the authors noted.

The study, “Lipoic acid in secondary progressive MS,” was published online in the journals Neuroimmunology and Neuroinflammation.

A press release regarding the study was made available.

Related Coverage:

Scientists ID Gene Variant That May Contribute to MS

Q&A: Medical Marijuana for Multiple Sclerosis​

Statin Improves Cognition in Patients with SPMS