Mon, Mar. 31, 2003
By Linda Lamb
Knight Ridder Newspapers
A drug commonly prescribed to lower cholesterol may also treat the devastating effects of multiple sclerosis, medical researchers said Monday.
It is hoped that further studies will support use of the drug - simvastatin, known as Zocor - to help patients with the neurological disorder, which afflicts 2.5 million people worldwide.
"It's a relatively safe drug, and it's relatively inexpensive," said Dr. L. Lyndon Key of the Medical University of South Carolina (MUSC), who helped design the study.
The drug appears to work by decreasing the brain lesions that cause such symptoms as weak or spastic muscles, pain, fatigue and paralysis.
And unlike the drugs most commonly used by MS patients, it is taken orally, not by injection. That's important to people like Lisa Kleinfelder of Lexington, S.C., whose treatments for MS have included one medication that required injections every other day for nine years.
"Finally I told my doctor I was sick of taking shots," said Kleinfelder, 44. "I felt like a human pincushion."
Kleinfelder has "secondary progressive" MS, meaning she suffers symptoms that are steadily getting worse.
Symptoms vary widely among patients and may include muscle weakness, loss of coordination, vision problems, fatigue, stiff or spastic muscles, tremors, paralysis, pain and incontinence.
The new study involved patients in an earlier phase of the disease, the "relapsing-remitting" stage. About 80 percent of multiple sclerosis patients have this diagnosis initially.
They have flare-ups of symptoms followed by periods of few or no symptoms.
The research started six years ago with experimentation by MUSC's Inderjit Singh.
He is a pediatric researcher whose specialty is a rare genetic disorder, adrenoleukodystrophy, which afflicted the boy portrayed in the movie "Lorenzo's Oil."
He found that drugs like simvastatin reduced damage of brain inflammation, first in cell cultures and then in rodents.
A trial for humans was designed by Singh, Key and Dr. Timothy Vollmer of the Barrow Neurological Institute in Phoenix. It started in December 2000 and lasted almost two years. It was carried out at MUSC in Charleston, S.C., Yale University and the University of Colorado's Denver Health Sciences Center.
Multiple sclerosis can start subtly. In Kleinfelder's case, her legs felt numb, that's all.
Symptoms occur following inflammation and breakdown of myelin, the protective insulation around nerve fibers of the brain and spinal cord. Multiple hardened or "sclerotic" lesions appear and disrupt transmission of nerve signals from the brain to the rest of the body.
Patients in the study had to have developed at least one lesion. Magnetic resonance imaging scans charted their progress.
Key said the study found a 43 percent decrease in the number of active lesions, and a 41 percent decrease in the volume of brain tissue affected.
Of the 28 patients, two had an increase in lesions and 23 showed a decrease; three showed no change.
"Certainly, we're encouraged by the fact that it seems to offer some neuroprotection," Key said.
Lonnie Atkins of Eastover was diagnosed with MS in 1990, but he's still in the relapsing-remitting stage. He is the type of patient for whom the new study is most promising.
After every relapse, "I always lose a little bit," said Atkins, 48. He has problems with
fatigue and spastic muscles and uses an electric scooter to get around.
"I see people who were in the same shape I was 10 years ago and are in wheelchairs now. I'm one of the lucky ones."
Kleinfelder, also diagnosed in 1990, does use a wheelchair. She's thankful she could move about more easily when her son, now 20, was younger. She has periods she calls "MS meltdowns" when she loses the use of her legs.
"Some days you feel like a million dollars, then the next day you feel like crap," said Kleinfelder, a former bank vice president.
She has tried many medications, currently relying on a weekly injection of Avonex and regular treatments with steroids.
The researchers don't advise MS patients to start taking Zocor. Larger studies will have to be done, Key said, and FDA approval of the drug to treat MS may be years away.
MUSC will participate in the next stage of studies, which may start in a few months.
Definite information is not available now, but might be posted later
on www.musc.edu - search for "Catalyst" and click on "research studies."
© 2003, The State (Columbia, S.C.)