High-dose biotin in progressive multiple sclerosis: A prospective study of 178 patients in routine clinical practice. (December 2020)

• Record Type: Journal Article
• Authors: Couloume, Laura; Barbin, Laetitia; Leray, Emmanuelle; Wiertlewski, Sandrine; Le Page, Emmanuelle; Kerbrat, Anne; Ory, Solenn; Le Port, Damien; Edan, Gilles; Laplaud, David-Axel; Michel, Laure
• Is Part Of: Multiple sclerosis. Volume 26:Number 14(2020)
• Page Start: 1898
• Page End: 1906
• Publication Date: 2020-12
• Subjects: Biotin -- multiple sclerosis -- primary progressive multiple sclerosis -- secondary progressive multiple sclerosis -- progression -- effectiveness; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/1352458519894713
• Languages: English
• ISSNs: 1352-4585

Abstract

Background: A recent controlled trial suggested that high-dose biotin supplementation reverses disability progression in patients with progressive multiple sclerosis. Objective: To analyze the impact of high-dose biotin in routine clinical practice on disability progression at 12 months. Methods: Progressive multiple sclerosis patients who started high-dose biotin at Nantes or Rennes Hospital between 3 June 2015 and 15 September 2017 were included in this prospective study. Disability outcome measures, patient-reported outcome measures, relapses, magnetic resonance imaging (MRI) data, and adverse events were collected at baseline, 6, and 12 months. Results: A total of 178 patients were included. At baseline, patients were 52.0 ± 9.4 years old, mean Expanded Disability Status Scale (EDSS) score was 6.1 ± 1.3, mean disease duration was 16.9 ± 9.5 years. At 12 months, 3.8% of the patients had an improved EDSS score. Regarding the other disability scales, scores either remained stable or increased significantly. In total, 47.4% of the patients described stability, 27.6% felt an improvement, and 25% described a worsening. Four patients (2.2%) had a relapse. Of the 74 patients (41.6%) who underwent an MRI, 20 (27.0%) had new T2 lesions, 8 (10.8%) had gadolinium-enhancing lesions. Twenty-five (14%) reported adverse event. Conclusion: In this study, high-dose biotin did not seem to be associated with a clear improvement in disability.