Can cholesterol drugs help slow MS progression?

Sometimes, an old drug learns new tricks. That could be the case with a common cholesterol-lowering drug that shows potential in preventing disability from multiple sclerosis (MS).

While more study is needed to confirm results, it appears that certain statins may have a neuroprotective effect and reduce inflammation in people with MS. This may help slow brain shrinkage (also known as atrophy) and the progression of disability, specifically in patients with secondary progressive multiple sclerosis (SPMS).

Research is promising, though mixed

A 2019 study in PNAS found that patients with SPMS experienced an improvement in disability status after being treated with the statin simvastatin. The researchers found that 31 percent of the change in disability in those patients was attributable to a decrease in brain atrophy. In a previous 2014 article in The Lancet, high doses of simvastatin were shown to slow brain atrophy in people with SPMS.

In the Lancet study, people with SPMS were given either simvastatin or a placebo over two years. The group taking simvastatin showed a 43 percent reduction in the rate of brain shrinkage, based on MRIs scans. Patients given simvastatin also reported modest improvements in disability outcomes.

Research on whether statins can improve other types of MS—including relapsing-remitting (RRMS) and progressive MS—have not been as encouraging, however. A 2021 analysis of research on the topic in Cureus found that statins may be helpful in SPMS but haven’t shown benefit in other types of MS. A meta-analysis from the journal CNS Drugs in 2015 found that statins may even worsen disease activity in people with RRMS.

How might statins benefit patients?

For people with SPMS, statins could have advantages over other treatments being evaluated for MS. Statins like simvastatin have already been approved by the FDA to treat high cholesterol and have a good safety record. Plus, they are cheap and covered by most insurance plans.

More, and larger, studies are needed to support the potential benefits of statins on MS. In particular, researchers need to show that the improvement in brain atrophy will translate into less disability for people with SPMS.

If you have MS, you might want to talk with your healthcare provider (HCP) about whether taking simvastatin makes sense for you. Patients should remember, however, that using simvastatin for MS treatment may be considered off-label, so it should only be done under the guidance of an HCP. They can help you assess potential risks and benefits and to weigh the value of statins against other MS treatments that are available.