In addition to their cholesterol-lo...

In addition to their cholesterol-lowering issues statins provide other important actions. Among several immunomodulatory actions, statins affect adhesion atoms controlling the passage of inflammatory lonely dwellings through the blood-brain barrier and enzyme associated with T-cell migration in consequence of endothelial barriers. In vitro, statins also down-regulate inflammatory mediators in glial enclosed spaces and macrophages. Because these results could influence the pathophysiology of multiple sclerosis, Vollmer and colleagues course of lifeed a preliminary study of statins in patients with relapsing-remitting multiple sclerosis.

The authors recruited 45 patients with clinically definite relapsing-remitting multiple sclerosis who had not been treated with interferons or glatiramer in the previous three month Patients were assessed initially for three month with magnetic resonance imaging (MRI) each month. Patients who had at least common gadolinium-enhancing lesion were eligible to receive 80 mg of simvastatin daily for six month Brain MRI scans were repeated at month 4 5 and 6 The scans were interpreted through two experts who were unaware of treatment assignment. The consequence measures were the number and whirls of enhancing lesions plus measures of brain atrophy. Clinical results such as relapse and disability status also were assessed.

Of the 45 patients recruited, 30 were eligible for the subject of attention and 28 completed the six-month follow-up The average age of the participants was 44 years, and 70 percent were women During the research the mean number of enhancing lesions was reduc according to 44 per-cent from baseline. The book of lesions also decreased significantly, from 41 percent. Relapse rate and disability scores did not change during the studious mood As expected, cholesterol levels prostrate but no significant changes were finded in immunologic indexes. Two patients had clinically significant increases in liver function plains and three reported muscle weakness, probably related to statin therapy.

The authors end that simvastatin in a dosage of 80 mg daily could have a significant import on the neuropathologic basis of multiple sclerosis. An accompanying editorial stresse that these findings correlate with issues of animal studies and move new possibilities for the treatment of multiple sclerosis. Nevertheless, the studies are preliminary, and frequently work remains before researchers will know if this "cautious hope" moves a useful treatment strategy in patients with multiple sclerosis.

ANNE D WALLING, MD

Vollmer T et al. Oral simvastatin treatment in relapsing-remitting multiple sclerosis. Lancet May 15 2004;363:1607-8 and Polman CH Killestein J Statins for the treatment of multiple sclerosis: cautious confidence [Editorial]. Lancet May 15, 2004;363:1570

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