Albuterol for patients with multiple sclerosis?

January 01, 0001

Albuterol for patients with multiple sclerosis?

Interleukin 12 (IL-12), a cytokine that promotes generation of helper T cells subtype 1, is increased in multiple sclerosis. Albuterol sulfate, a beta-adrenergic agonist, reduces IL-12 expression, so these US authors tested the effect of albuterol as an add-on treatment to glatiramer acetate therapy in a double-blind clinical trial. Subjects with relapsing-remitting multiple sclerosis were randomized to receive a subcutaneous injection of glatiramer acetate (20 mg) plus an oral dose of placebo daily for 2 years or a subcutaneous injection of glatiramer acetate (20 mg) plus an oral dose of albuterol daily for 2 years. The primary clinical efficacy measurement was the change in Multiple Sclerosis Functional Composite at 2 years, and the primary immunologic end point was the change in expression of IL-13 and interferon at each study time point.

They found: "Forty-four subjects were randomized to receive glatiramer acetate plus albuterol or glatiramer acetate plus placebo, and 39 subjects contributed to the analysis. Improvement in the Multiple Sclerosis Functional Composite was observed in the glatiramer acetate plus albuterol group at the 6-month and 12-month time points but not at the 24-month time point. A delay in the time to first relapse was also observed in the glatiramer acetate plus albuterol group. Immunologically, IL-13 and interferon- production decreased in both treatment groups, and a treatment effect on IL- 13 production was observed at the 12-month time point. Adverse events were generally mild, and only 3 moderate or severe events were considered related to the treatment."

The authors concluded: "Treatment with glatiramer acetate plus albuterol is well tolerated and improves clinical outcomes in patients with multiple sclerosis."

Lack of efficacy at the 24-month time point makes these results less impressive.

For the full abstract, click here.

Arch Neurol 67(9):1055-1061, September 2010
© 2010 to the American Medical Association
A Randomized Controlled Double-Masked Trial of Albuterol Add-on Therapy in Patients With Multiple Sclerosis. Samia J. Khoury, Brian C. Healy, Pia Kivisakk, et al. Correspondence to Dr. Khoury: [email protected]

Category: N. Neurological. Keywords: multiple sclerosis, albuterol, interleukin 12, glatiramer, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo Ohio. Posted on Global Family Doctor 28 September 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.