Simvastatin in Multiple Sclerosis

Multiple sclerosis is a debilitating, immune-mediated disease of the central nervous system.  According to the Multiple Sclerosis Foundation, there are an estimated 2.5 million people with MS worldwide.  While novel therapies exist that modify the disease by preventing progression and relapse, these treatments are expensive and come with a host of adverse effects.  Moreover, there are limited treatment options that are FDA-approved for some of the progressive forms of MS.

Researchers are examining existing small-molecule therapies that are not currently FDA-approved for MS to see if they can be repurposed to treat this disease.  For example, simvastatin is an inexpensive cholesterol lowering drug that is being investigated in patients with secondary progressive MS (SPMS).  Preliminary studies have shown that taking high doses of simvastatin correlated with a significant reduction in the rate of brain atrophy over 2 years.  This led to improved disability and quality of life scores.  The phase III clinical trial is underway and expected to last six years, expected to end in 2023.  There are several other generic agents that are being tested in multiple sclerosis in addition to simvastatin including miconazole, minocycline and others. What do you think about repurposing a genericized therapy in a complicated disease state like MS?

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