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A pilot test of pioglitazone as an add-on in patients with relapsing remitting multiple sclerosis.

Abstract：

:The peroxisome proliferator-activated receptor gamma agonist pioglitazone is FDA-approved for treatment of type-2 diabetes due to insulin sensitizing effects. However pioglitazone has anti-inflammatory and neuroprotective effects, reduces glial and T-cell activation, and reduces signs in an animal model of multiple sclerosis (MS). We tested the effects of daily treatment with pioglitazone in a small cohort of relapsing remitting MS patients. RRMS patients taking IFNbeta-1alpha and having an EDSS score <6.5 were randomized to treatment with pioglitazone (30 mg daily, p.o.) or placebo and monitored clinically and by MRI for 1 year. Primary outcomes were safety and tolerability, secondary outcomes included changes in neurological outcome, lesion burden, and gray matter volume. After 1 year 11 patients in the pioglitazone arm and 10 in the placebo arm completed the trial. Pioglitazone was well tolerated with a similar incidence of non-serious adverse events in placebo and treatment groups. After 1 year there were no significant differences in clinical symptoms as assessed by EDSS; however MRI showed a significant reduction in gray matter atrophy, and a trend for reduced lesion burden in the treatment group. These results show that pioglitazone was well tolerated in RRMS patients with indications of beneficial effects, warranting further trials to establish clinical efficacy.

journal_name

J Neuroimmunol

journal_title

Journal of neuroimmunology

authors

Kaiser CC,Shukla DK,Stebbins GT,Skias DD,Jeffery DR,Stefoski D,Katsamakis G,Feinstein DL

doi

10.1016/j.jneuroim.2009.04.011

subject

Has Abstract

pub_date

2009-06-25 00:00:00

pages

124-30

issue

1-2

eissn

0165-5728

issn

1872-8421

pii

S0165-5728(09)00146-5

journal_volume

211

pub_type

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