Effect of pioglitazone treatment in a patient with secondary multiple sclerosis release_ryulq3is3fba5hobt7ibapqllq

by Harrihar A Pershadsingh, Michael T Heneka, Rashmi Saini, Navin M Amin, Daniel J Broeske, Douglas L Feinstein

Published in Journal of Neuroinflammation.

2004   Volume 1, Issue 1, p3

Abstract

BACKGROUND: Ligands of the peroxisome proliferator-activated receptor-gamma (PPARgamma) induce apoptosis in activated T-lymphocytes and exert anti-inflammatory effects in glial cells. Preclinical studies have shown that the thiazolidinedione pioglitazone, an FDA-approved PPARgamma agonist used to treat type 2 diabetes, delays the onset and reduces the severity of clinical symptoms in experimental autoimmune encephalomyelitis, an animal model of multiple sclerosis (MS). We therefore tested the safety and therapeutic potential of oral pioglitazone in a patient with secondary MS. CASE PRESENTATION: The rationale and risks of taking pioglitazone were carefully explained to the patient, consent was obtained, and treatment was initiated at 15 mg per day p.o. and then increased by 15 mg biweekly to 45 mg per day p.o. for the duration of the treatment. Safety was assessed by measurements of metabolic profiles, blood pressure, and edema; effects on clinical symptoms were assessed by measurement of cognition, motor function and strength, and MRI. Within 4 weeks the patient exhibited increased appetite, cognition and attention span. After 12 months treatment, body weight increased from 27.3 to 35.9 kg (32%) and maintained throughout the duration of the study. Upper extremity strength and coordination improved, and increased fine coordination was noted unilaterally after 8 months and bilaterally after 15 months. After 8 months therapy, the patient demonstrated improvement in orientation, short-term memory, and attention span. MRIs carried out after 10 and 18 months of treatment showed no perceptible change in overall brain atrophy, extent of demyelination, or in Gd-enhancement. After 3.0 years on pioglitazone, the patient continues to be clinically stable, with no adverse events. CONCLUSIONS: In a patient with secondary progressive MS, daily treatment with 45 mg p.o. pioglitazone for 3 years induced apparent clinical improvement without adverse events. Pioglitazone should therefore be considered for further testing of therapeutic potential in MS patients.
In text/plain format

Archived Files and Locations

application/pdf  607.6 kB
file_stt4oir3lnbstitkmmyzda5wcm
www.jneuroinflammation.com (publisher)
web.archive.org (webarchive)
application/pdf  1.3 MB
file_my2njd7etjh3ffuzrpc32sjr54
web.archive.org (webarchive)
jneuroinflammation.biomedcentral.com (web)
Read Archived PDF
Preserved and Accessible
Type  article-journal
Stage   published
Date   2004-04-20
Language   en ?
Journal Metadata
Open Access Publication
In DOAJ
In ISSN ROAD
In Keepers Registry
ISSN-L:  1742-2094
Work Entity
access all versions, variants, and formats of this works (eg, pre-prints)
Catalog Record
Revision: 4423fb37-d624-4e72-bf92-79e76b1cd190
API URL: JSON