#ECTRIMS2016 – Antioxidant Lipoic Acid Appears to Slow SPMS Patients’ Neurodegeneration

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Lipoic acid in SPMS

A pilot study exploring the antioxidant lipoic acid in patients with secondary progressive multiple sclerosis (SPMS) demonstrated that treatment for two years reduced the speed of brain tissue loss and improved the patients’ walking speed.

The surprising finding was presented during the “New directions in progressive MS research” session of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) 2016 Congress Sept. 14-17 in London.

In her talk, titled “Lipoic acid for neuroprotection in secondary progressive multiple sclerosis: results of a randomised placebo-controlled pilot trial,” Dr. Rebecca Spain, MD, MSPH, a neurologist in the Oregon Health & Science University Multiple Sclerosis Center, also working with the VA Portland Health Care System, explained how her research team became interested in the over-the-counter antioxidant.

Lipoic acid has been shown to reduce inflammation and degeneration of the optic nerve and spinal cord tissue in animal models of MS. The compound is also suitable for patients, as studies have shown that even high doses of the antioxidant are well-tolerated.

Spain and her team designed a clinical trial where patients were randomized to receive either 1,200 mg of lipoic acid or a placebo for 96 weeks. The main goal of the study was to reduce whole brain tissue loss, but researchers also measured neurodegeneration in the spinal cord and eye. The team also assessed neurological functions, cognition, walking, fatigue, and quality of life.

The study enrolled 51 patients, of whom 27 received lipoic acid and 24 a placebo. Patients in the study were, on average, 58.5 years old, and had an average Expanded Disability Status Scale (EDSS) score of 6.

Five participants in the lipoic acid group, equaling 9.8 percent, quit the study early, but the remaining patients took about 80 percent of their daily lipoic acid doses.

Researchers found that the annualized rate of whole brain tissue loss was significantly lower in patients receiving lipoic acid. After two years, treated patients had lost about 0.4 percent of their total brain volume, while those in the control group lost 1.3 percent during the same time. Those receiving lipoic acid were also found to walk faster.

The treatment did not increase the occurrence of adverse events, but researchers noted that lipoic acid was linked to more stomach problems. Those receiving a placebo, however, fell more often.

“If these findings bear out, it provides hope for a relatively inexpensive treatment where few currently exist for people living with longstanding progressive multiple sclerosis,” Spain told Multiple Sclerosis News Today.

“The slowing of whole brain atrophy was remarkable. We can use this pilot study as the basis for designing a multisite clinical trial, which will help us answer questions about how lipoic acid works and whether it can indeed improve clinical outcomes for people,” she said.

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    • Magdalena KegelMagdalena Kegel says:

      I’m not sure what you mean by formula. Lipoic acid is also sold as α-lipoic acid, alpha lipoic acid and thioctic acid, but it is the same compound.

      • sammy says:

        There is an R or S formula of organic molecules.
        Believe R-Lipoic Acid is the one most used…but
        it would be nice to know for sure what they used.

        • sammy says:

          some more info. on R-ALA

          Most alpha lipoic acid (ALA) products contain a racemic mixture of R-Alpha Lipoic Acid (R-ALA) and S-Alpha Lipoic Acid (S-ALA). Generally, equal amounts of R- and S- forms are produced during the manufacturing process of alpha lipoic acid, and thus, these products contain R-ALA and S-ALA in an equal ratio of 1:1. However, R-ALA is the only form of lipoic acid that is endogenously synthesized in humans and other organisms. Human pharmacokinetic studies have shown that peak concentrations of R-ALA are 40-50% higher than S-ALA after oral supplementation of racemic preparations, suggesting that R-ALA may have better absorption and bioavailability. In animal studies, R-ALA supplementation has shown better biological effects such as insulin-stimulated glucose transport, glucose metabolism, and antioxidative status. Thus, R-ALA may provide superior health benefits compared to racemic mixtures (R-ALA and S-ALA) or S-ALA alone.

          • Magdalena KegelMagdalena Kegel says:

            Thank you Sammy for clarifying. I was not aware that that supplements were synthesized as pure enantiomeres, as this is more complex than synthesizing the racemic mixture. It would be best to contact the author to find out what kind they used.

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