Date of Graduation

8-14-2010

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Mary Von PA-C, MS, DFAAPA

Second Advisor

Annjanette Sommers MS, PAC

Third Advisor

Rob Rosenow PharmD, OD

Abstract

Background: Multiple sclerosis (MS) is believed to be an autoimmune disease that creates an inflammatory process that breaks down the blood brain barrier (BBB) allowing the immune system to attack the myelin sheaths of the central nervous system (CNS). MS can be treated with a variety of disease modifying drugs (DMD) that decrease the immune system’s attack on the myelin sheaths of the CNS. In the past few decades, three-hydroxy-three-methylglutaryl coenzyme A reductase inhibitors, known as statins, have been suggested to have anti-inflammatory effects that will reduce the permeability of the BBB. This review is to investigate the trials that have been done involving the use of statins as monotherapy, or in combination with an interferon DMD, as treatment in relapse-remitting MS (RRMS).

Methods: An extensive review of MEDLINE, CINAHL, Web of Science, and MDConsult, was performed to find human trials that used statins with or without beta interferons to treat RRMS. The research also looked for the trials that measured the number of contrasted enhanced lesions on T1 sequenced magnetic resonance imaging.

Results: The three trials reviewed had differing results. The Birnbaum et al trial concluded that statins may have an adverse effect on the disease activity of RRMS and should be used with caution. The Paul et al trial concluded that statins were safe, well tolerated, and had possible benefits in treating RRMS. The Rudick et al trial concluded that statins did not affect the treatment of RRMS.

Conclusion: The question of how effective statins are in the treatment of RRMS, is yet to be resolved. There is a need for large population trials with of long duration that focus their outcomes on the clinical aspect of treating RRMS.

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