Statin Benefits Secondary Progressive MS

HMG-CoA reductase inhibitors are postulated to have immunomodulatory effects that appear to be independent of their effect on cholesterol. A benefit has been suggested in early multiple sclerosis (MS) based on reduction of magnetic resonance imaging brain lesions (NEJM JW Neurol May 22 2012). In this multicenter, double-blind study, investigators randomized 140 participants with secondary progressive (SP) MS to 80 mg of simvastatin or placebo daily for 2 years. Participants were 18 to 65 years old, had active progression over the preceding 2 years, and had difficulties ambulating but were not wheelchair bound (Expanded Disability Status Scale [EDSS] score range, 4.0–6.5).

Whole brain atrophy (the primary endpoint) was 43% slower annually in …