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Published online before print June 4, 2008, doi:10.1212/01.wnl.0000319698.40024.1c)
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 Volume 71, Number 18, October 28, 2008
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Received August 13, 2007
Accepted April 28, 2008

Combining beta interferon and atorvastatin may increase disease activity in multiple sclerosis

G. Birnbaum MD*, B. Cree MD, PhD, MCR, I. Altafullah MD, M. Zinser RN, BSN, and A. T. Reder MD

From the MS Treatment and Research Center (G.B., I.A.), Minneapolis Clinic of Neurology, MN; Department of Neurology (B.C.), University of California San Francisco; and Department of Neurology (A.T.R.), Pritzker School of Medicine, University of Chicago, IL.


* To whom correspondence should be addressed. E-mail: birnb001{at}tc.umn.edu.

Objective: To explore whether high dose atorvastatin can be administered safely to persons with relapsing remitting multiple sclerosis (MS) taking thrice weekly, 44 mcg dose subcutaneous interferon beta-1a.

Methods: Persons with clinically stable, relapsing remitting MS, on standard high dose subcutaneous interferon beta-1a, were randomized in a double blinded fashion to receive either placebo or atorvastatin at dosages of 40 mg or 80 mg per day for 6 months. Blinded neurologic examinations and brain MRI readings were obtained at months 0, 3, 6, and 9. Laboratory blood testing was performed monthly. Main outcome measures were the determination of drug toxicity using blood tests and ECG and determination of MS-related disease activity, either clinical relapses, or new or contrast enhancing lesions on MRI.

Results: Twenty-six subjects received at least one dose of study drug. Ten of 17 subjects on either 80 mg or 40 mg of atorvastatin per day had either new or enhancing T2 lesions on MRI or clinical relapses. One of the nine subjects on placebo had a relapse with active lesions on MRI. The subjects receiving atorvastatin were at greater risk for either clinical or MRI disease activity compared to placebo (p = 0.019). Significant changes in blood tests were noted only for lower cholesterol levels in subjects receiving atorvastatin.

Conclusion: The combination of 40 or 80 mg atorvastatin with thrice weekly, 44 mcg interferon beta-1a in persons with multiple sclerosis resulted in increased MRI and clinical disease activity. Caution is suggested in administering this combination.


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Correspondence:

Read all Correspondence

Combining beta interferon and atorvastatin may increase disease activity in multiple sclerosis
Silva Markovic-Plese, et al.
Neurology Online, 30 Sep 2008 [Full text]
Reply from the authors
Gary Birnbaum, MD, et al.
Neurology Online, 30 Sep 2008 [Full text]
Combining beta interferon and atorvastatin may increase disease activity in multiple sclerosis
Elena Salvatore, et al.
Neurology Online, 14 Dec 2008 [Full text]
Reply from the author
Gary Birnbaum, et al.
Neurology Online, 14 Dec 2008 [Full text]

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