# Lipoic acid for the treatment of progressive multiple sclerosis

> **NIH VA I01** · PORTLAND VA MEDICAL CENTER · 2020 · —

## Abstract

At any time, nearly half of the 500,000 people in the United States living with multiple sclerosis
(MS), a common and disabling neuro-inflammatory disease of the central nervous system, have
a progressive course. Despite the explosion of new MS therapies, there remains a frustrating
lack of disease-modifying therapies that can alter the functional decline of progressive MS
(PMS) that resulting in reduced community participation, low quality of life, and high burdens on
health care systems and caretakers.
Lipoic acid (LA) is an inexpensive, endogenously-produced, oral antioxidant with multiple
biological functions implicated in the pathogenesis of PMS. LA reduces disability in a dose-
dependent fashion in the animal model of MS, and is safe and tolerated in people with MS. A 2-
year randomized, double-blind, placebo-controlled clinical trial of daily oral LA in secondary
progressive MS, a subset of PMS patients, demonstrated a remarkable 68% reduction in the
annualized rate of whole brain atrophy, the current gold-standard MRI biomarker in PMS. While
not powered to do so, the LA cohort exhibited a trend toward improvement in walking tests and
a reduction in falls.
This study proposes to expand on the highly promising preliminary results to confirm the effects
of LA on reducing rates of brain atrophy and to determine its associated clinical benefits. The
design is a multi-center, double-blind, randomized, placebo-controlled trial of oral daily LA in a
PMS population with the following objectives:
 1. Determine if LA is superior to placebo in maintaining a clinically meaningful outcome,
 mobility, as measured by the primary outcome of change in completion time of the Timed
 25 Foot Walk as suggested by the pilot study. Falls and other walking tests will be
 evaluated to confirm the primary outcome results.
 2. Determine if LA is superior to placebo in slowing whole brain atrophy with an estimated
 40-50%% effect size. This will confirm our previous findings of a significant 68% reduction
 in brain atrophy rate at a more modest effect size that is in line with protection of brain
 atrophy rates from relapsing MS trials. Additional secondary outcome measures will
 include neurological disability, cognition, mood, and quality of life.
 3. Monitor safety and tolerability via laboratory testing and adverse event reporting.
Participants at 3 or 4 sites with PMS will be randomized on a 1:1 basis to LA or placebo.
Participants will be enrolled over 18 months and complete 7 study visits over 2 years. Walking
tests will be performed at every visit. MRIs will be completed at baseline and study end.
Secondary endpoints not related to MRI will be collected at study visits every 6 months. Safety
labs will be collected at every study visit and adverse events every 3 months. The sample size
of 50 per arm will allow for a 15% drop-out rate.
The Portland VA Medical Center will be the lead coordinating site. Monthly conference calls and
biannual site visits will assur...

## Key facts

- **NIH application ID:** 9905320
- **Project number:** 5I01RX002682-03
- **Recipient organization:** PORTLAND VA MEDICAL CENTER
- **Principal Investigator:** Rebecca I Spain
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-05-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9905320

## Citation

> US National Institutes of Health, RePORTER application 9905320, Lipoic acid for the treatment of progressive multiple sclerosis (5I01RX002682-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9905320. Licensed CC0.

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