Researchers from University College London and Queens Square have published an important paper in the Lancet. Treating 140 people with progressive MS over two years with one of the statins (drugs that improve the fat profile often used to treat heart disease) in a randomised controlled trial with a control group taking a placebo, the researchers found that MRI scanning showed 43% less brain shrinkage in the group on the statins than those on placebo.
Brain shrinkage in people with progressive MS has been shown in the past to correlate with worsening disability. In this study, presumably because of the short time frame, they were only able to show a very slight improvement in disability in the treated group of a quarter of a point on the 12 point EDSS.
Naturally, the researchers were very upbeat about the findings, arguing that to date, nothing has been shown to affect the worsening course in progressive MS, describing it as 'untreatable'. Dr Susan Kohlhaas, speaking on behalf of the MS Society of the UK about the results, also commented that there are "no treatments that can stop the condition from worsening...".
This of course conveniently ignores the work of Swank, who showed dramatic slowing of disability progression in those who stuck to a low saturated fat diet. One has to wonder about these statements, and the researchers speculation about how these drugs might be having their effect on slowing of disease progression.
The researchers found no difference in any of the immune parameters they measured, that is the balance between Th1 and Th2 cytokines, showing that the drug appeared to have no real effect on the tendency towards inflammation.
They argued that perhaps the drug worked through protecting nerve cells, previously documented with this drug. Finally they suggested that because it is known that people with MS have more cardiovascular disease, that it might be working through this effect, given that the drug is used to treat cardiovascular disease, and the fact that they did notice a drop in cholesterol in the group taking the statins.
In fact, when you looked at it closely, it was a very large drop in cholesterol in the treated group, of around 25%. But what are the real implications of this study? Statins have their beneficial effect in heart disease through several mechanisms, the major one being an improvement in the lipid profile (balance of good and bad fats in the blood).
Until recently, when statins seem to be the first line treatment in heart disease, doctors have always advised people with poor lipid profiles and high risk of heart disease to modify their diets to reduce saturated fat, among other lifestyle changes.
This dietary change can improve lipid profiles and lower cholesterol more than the statins do if applied rigorously. What this study really reaffirms is that changing lipid profile towards a healthier balance of good and bad fats results in significant slowing of disease progression, even for people with progressive MS.
This is exactly in accord with the findings of Swank and the OMS recommendations. Except that we suggest using diet to achieve this improved lipid profile, because a very low saturated fat diet is also associated with many other health benefits (reduced risk of many other chronic Western diseases) and has only beneficial side effects, unlike the statins.
It is somewhat surprising that these researchers did not discuss this in the paper. It is highly likely that many doctors treating people with progressive MS will now start offering statins to them, while continuing to ignore the most fundamental approach to good health and slowed MS progression, a rigorously applied ultra-healthy plant-based wholefood diet plus seafood.