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Testosterone May Benefit Men With Multiple Sclerosis

By Randy Dotinga
HealthDay Reporter

MONDAY, May 14 (HealthDay News) -- Testosterone gel may slow the progression of multiple sclerosis in men with the disease, a new study suggests.

Only 10 men took part in the research, all had milder forms of MS, and more studies will be needed before doctors determine whether the treatment really works. Still, the researchers were impressed that the men's mental decline ceased, and the shrinking of their brains returned to the normal levels expected due to aging.

"We saw an improvement which was exciting," said study co-author Dr. Rhonda Voskuhl, professor of neurology at the University of California, Los Angeles. "This looks like it would be neuroprotective, which would be great."

But another expert, Dr. Moses Rodriguez, professor of neurology and immunology at the Mayo Clinic, said he was skeptical that the treatment would become common and noted that MS research has had a history of promising therapies that ultimately failed.

A treatment that protects the central nervous system against multiple sclerosis would be a major breakthrough for the 400,000 Americans with the disease. MS is thought to be caused when the immune system attacks the myelin sheath, a fatty substance that insulates nerves in the brain and spinal cord. It can cause a wide range of symptoms, from cognitive decline and pain to severe fatigue and difficulty walking. Most people with the disease have normal or near-normal life spans.

Women are two to three times more likely to get the disease, and there has been speculation that testosterone -- the male hormone -- could protect men against MS.

While injection drugs can slow the progress of the disease, researchers have been trying to find a way to boost their effectiveness.

In the new study, the researchers followed 10 men with mild MS who, for a variety of reasons, chose not to take injection treatments. The average age of the participants was 46. After the researchers monitored the men's conditions for six months, each man applied 10 grams of a gel containing 100 milligrams of testosterone to his upper arms once daily for 12 months.

"The cognition improved instead of declining," Voskuhl said. "We were pretty surprised by seeing an improvement." The study authors also found that the rate of brain atrophy declined by two-thirds, to the rate expected during normal aging. In another promising sign, the men ended up with more muscle mass after undergoing the treatment.

Unfortunately, testosterone treatment would not be feasible in women because of its side effects, Voskuhl said. But researchers are looking into other possible treatments for women.

Voskuhl also thinks that testosterone treatment -- if it turns out to work in other studies -- could lead to better therapies for diseases such as Alzheimer's and Parkinson's.

The findings are published in the May issue of the Archives of Neurology.

But the Mayo Clinic's Rodriguez, who's familiar with the study findings, said he doubts that testosterone therapy will become standard, because it has side effects and has been connected to an increased risk of prostate cancer. Also, much promising but preliminary MS research fails to bear fruit, he said.

Voskuhl said further research will take three to five years, largely because it takes time to get funding. Doctors could legally give testosterone to MS patients now, but she said it's not approved for that purpose.

"You really should wait until the larger trials are finished and we go for FDA (U.S. Food and Drug Administration) approval," Voskuhl said.

However, Rodriguez believes MS patients would be taking a "great risk" if they underwent testosterone treatment before it was federally approved for that purpose.

More information

Learn more about MS from the National Multiple Sclerosis Society.

This story is over a year old - see below. As usual not much progress with a relatively safe / cheap treatment. You really get the feeling that the researchers lack any sense of urgency.

Perhaps our resident guinea pig - CureorBust could add it to his regime?

Ian



Men With Multiple Sclerosis May Benefit From Testosterone Treatment

Men with multiple sclerosis may experience improvements in cognitive function and a slowing of brain atrophy with testosterone therapy, according to research that will be presented at the American Academy of Neurology 58th Annual Meeting in San Diego, Calif., April 1 – 8, 2006.
While men are less susceptible to many autoimmune diseases, including MS, the reason is not known. In men, the age at onset of MS is generally later than in women, and coincides with a decline in testosterone levels. Testosterone may serve to protect the nerve cells that are damaged by the autoimmune attack on myelin that occurs in MS and maintaining cognitive function (the ability to think, reason, concentrate or remember).

Researchers from the University of California at Los Angeles recently conducted the first study of testosterone treatment in men with relapsing-remitting MS. Relapsing-remitting MS (RRMS) is characterized by relapses during which time new symptoms can appear and old ones resurface or worsen, followed by periods of remission, during which time the person fully or partially recovers from the relapse.

The 10 patients in the pilot study received daily treatment with 100 mg of testosterone gel applied to the skin for a period of one year. None of the men was currently taking immunomodulating drugs (drugs that control the immune system) for MS. Clinical assessments including cognitive measures and blood tests were obtained every three months, and magnetic resonance images were reviewed monthly.

Compared to the pretreatment period, significant improvements in performance on the Paced Auditory Serial Addition Task (PASAT) were detectable after 12 months of treatment with testosterone. The PASAT is a test of processing speed and working memory function. While the improvements were small with testosterone treatment (about four percent), in previous studies of other MS treatments PASAT performance continued to worsen with treatment, although at a slower rate. In addition, with testosterone treatment, there were trends for improvements in tests of spatial memory as well.

Blood tests demonstrated that the production of a growth factor (brain-derived neurotrophic factor) that helps promote nerve cell survival increased more than two-fold after testosterone supplementation. Also, the rate of brain atrophy slowed by 67 percent during the last nine months of testosterone treatment.

“We found that the testosterone treatment resulted in significant improvements in cognitive function, increases in neurotrophic factor production and a slowing of brain atrophy,” said study author Nancy Sicotte, MD, of the David Geffen School of Medicine at UCLA. “There was no change in the number or size of MS-related lesions as measured by MRI, although lesion activity was low in the group overall. Our study results in this small group of patients suggest that testosterone therapy may have neuroprotective effects in RRMS, but further study using a placebo-controlled, blinded design in larger groups of men with RRMS is needed to confirm these preliminary results.”

The study was supported by the National Multiple Sclerosis Society.

The American Academy of Neurology, an association of more than 19,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer disease, epilepsy, multiple sclerosis, Parkinson disease, and stroke.

For more information about the American Academy of Neurology, visit http://www.aan.com.

Source: Newswise © 2006 Newswise. All Rights Reserved.