Lipoic Acid Slows Brain Deterioration in Secondary Progressive Multiple Sclerosis

Over-the-counter lipoic acid may be a viable treatment option for patients with secondary progressive multiple sclerosis (MS), a new study suggests.

Secondary progressive MS is a more severe form of the disease that, in many cases, follows relapsing-remitting MS. Symptoms include stiff leg muscles, an increase in weakness, trouble with coordination, and bowel and bladder problems. Currently, there are few treatment options for patients with this form of the disease.

In a study published in Neuroimmunology & Neuroinflammation, investigators sought to determine whether lipoic acid slowed the whole-brain atrophy rate and if it yielded any benefit in patients with secondary progressive MS. They conducted a 2-year, double-blind, randomized, controlled pilot study to examine the effects of lipoic acid versus placebo.

The primary outcome was changes in annualized percent change brain volume (PCBV). The secondary outcomes were changes in rates of atrophy of segmented brain, spinal cord, and retinal substructures, disability, quality of life, and safety.

A total of 51 patients with secondary progressive MS were included in the study, of whom, 27 received a daily dose of 1200 mg of lipoic acid and 24 received a placebo.

Using an MRI to measure the degree of brain tissue loss, the investigators observed a significant slowing of whole brain atrophy in patients who received the lipoic acid—–a 68% reduction in brain deterioration compared with placebo.

For comparison, a clinical trial of ocrelizumab (Ocrevus) showed an 18% improvement over placebo in the slowing of whole brain atrophy for patients with primary progressive MS, according to a press release.

Additionally, the study showed that participants who received lipoic acid achieved longer walking times and had fewer falls compared with the controls. The investigators hope to test this further in a larger clinical trial.

Lipoic acid was safe and well-tolerated among study participants, with upset stomach reported as the most common adverse event.

“These are high doses,” lead author Rebecca Spain, MD, MSPH, said in a release. “And while it seems safe, we don’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.”