Statin Improves Cognition in Patients with SPMS

A new study confirmed the positive benefits of statins on cognition in patients with secondary progressive multiple sclerosis (SPMS).

Scientists at University College London studied the impact of simvastatin on cognition, neuropsychology, and health-related quality of life after 24 months in patients with SPMS. They found both frontal lobe function and quality of life were improved. The study represents the largest SPMS cohort to date to be evaluated in a comprehensive longitudinal study.

“The study is clinically important because patients with MS, in particular those with progressive MS, have a significant but under-reported cognitive burden, such as memory, processing and mental flexibility,” lead author Jeremy Chataway (pictured), MA, PhD, of University College London, said. “We have shown in this early work that simvastatin can help that part of it."

The new study is based on a secondary analysis of a 140-person trial first reported on in 2014 by Chataway and his colleagues. The original study looked at brain atrophy in patients with SPMS, and found that simvastatin reduced the instance of brain atrophy in those patients by 43%, on an annualized basis.

The 140 patients received treatment at 3 British multiple sclerosis (MS) centers. Half of the group received high doses of simvastatin (80 mg), and tolerated it well, according to the researchers. The other 70 patients received placebo.

The study took place between 2008 and 2011. Patients were assessed three times — at study entry, at 12 months, and at 24 months. At each point, participants were given a battery of tests, including the British National Adult Reading Test, the Visual Object and Space Perception battery (cube analysis), and the Frontal Assessment Battery. The latter is often used to assess dementia.

In the new analysis, researchers found that after two years, SPMS patients who had taken the statin scored 1.2 points higher on the Frontal Assessment Battery, and 2.5 points higher on self-reported physical quality of life assessments.

Chataway said the study is particularly notable because, while a number of therapies appear to slow the progression of relapsing-remitting multiple sclerosis, there are few treatments to assist patients suffering from the more severe form, SPMS.

David Schley, PhD, of the MS Society of the UK, said the research addresses one of the most frustrating parts of living with MS.

“Cognitive issues — like problems with memory and thinking – are a common and distressing symptom for people with MS, so this is encouraging news,” Schley said.

Chataway and his co-authors cautioned that more study is needed to confirm their findings. For one thing, they noted that disease activity in MS patients is known to fluctuate over time, meaning it’s possible the results could be somewhat skewed. He also said that despite patient screenings, it is possible that other concurrent medical conditions might have impacted the patient’s cognition or response to the statin.

“This study is an important small step in reinforcing the need to study cognition in MS and to continue to advance its treatment,” Chataway said. “Following on from this study we would recommended focusing the study on those aspects of cognition which are most frequently affected.”

The research team hopes to further confirm their findings with a new Phase III study, which will start soon and be funded in part by the MS Society of the UK.

The statin study was titled, “Effect of high-dose simvastatin on cognitive, neuropsychiatric, and health-related quality-of-life measures in secondary progressive multiple sclerosis: secondary analyses from the MS-STAT randomised, placebo-controlled trial.” It was published online June 8 in The Lancet Neurology.

A press release regarding the study was made available.

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