Simvastatin in optic neuritis

Epub ahead of print: Tsakiri et al. Simvastatin improves final visual outcome in acute optic neuritis: a randomized study. Mult Scler. 2011 Sep 15.

Background: In recent years, small-scale clinical trials have indicated that statin exert immunomodulatory effects, with potential therapeutic implications for MS’ers.

Objective: To investigate whether simvastatin treatment (80 mg daily for 6 months) in patients with optic neuritis (ON) had a beneficial effect on visual outcome and on brain MRI.

Methods: 64 patients with acute ON were randomized to simvastatin treatment (n = 32) or placebo (n = 32) for 6 months. None of the patients had been on immunosuppressive therapy for 6 months prior to inclusion or treated with steroids from symptom onset. Contrast sensitivity (detecting shades of gray), visual acuity, colour perception, visual evoked potentials (VEP) – latency and amplitude, Visual Analogue Scale (VAS) score, and gadolinium enhancing and T2 lesions on brain MRI were evaluated at screening visit, day 14 (except brain MRI), day 90 and day 180.

Results: Simvastatin had a beneficial effect on VEP in both latency (p = 0.01) and amplitude (p = 0.01), a borderline effect on the Arden score (p = 0.06) and VAS (p = 0.04), and no effect on brain MRI or on relapse rate between the groups.

Conclusion: This study provides Class I evidence that simvastatin 80 mg daily is well tolerated and possibly effective in patients with acute ON.

“Interesting results that will need to be reproduced. Let’s wait and see what the Simvastatin secondary progressive trial shows.”

“These results conflict with other recent results: see previous post on ‘Statins don’t impact on disability‘”.

Please see: Investigation of Simvastatin in Secondary Progressive Multiple Sclerosis (MS-STAT)

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