This Is MS Multiple Sclerosis Knowledge & Support Community

Over-the-counter antihistamine repairs myelin damage in MS patients

The trial conducted with clemastine fumarate, an antihistamine used to treat common allergies, has been talked about in the news since the beginning of last year. Now the results from the phase II clinical trial have been published in The Lancet...Read more - http://www.ms-uk.org/over-counter-antih ... s-patients

Several years ago, went to a MS Society sponsored lecture by a doctor doing the same research. I believe this is his study:

https://clinicaltrials.gov/ct2/show/NCT02040298

Here is more info:

https://multiplesclerosisnewstoday.com/ ... stine-rrms


https://multiplesclerosisnewstoday.com/ ... rial-ucsf/


Thse articles claim limited success:

https://www.medscape.com/viewarticle/861963

http://www.msdiscovery.org/news/new_fin ... -new-trick



I am guessing that the overall results were not positive, or at least positive enough, otherwise we would know about it.

Here's a link to the full paper of the study...

Clemastine fumarate as a remyelinating therapy for multiple sclerosis (ReBUILD): a randomised, controlled, double-blind, crossover trial
The Lancet: Published online October 10, 2017

• Background: Multiple sclerosis is a degenerative inflammatory disease of the CNS characterised by immune-mediated destruction of myelin and progressive neuroaxonal loss. Myelin in the CNS is a specialised extension of the oligodendrocyte plasma membrane and clemastine fumarate can stimulate differentiation of oligodendrocyte precursor cells in vitro, in animal models, and in human cells. We aimed to analyse the efficacy and safety of clemastine fumarate as a treatment for patients with multiple sclerosis.
  
  Methods: We did this single-centre, 150-day, double-blind, randomised, placebo-controlled, crossover trial (ReBUILD) in patients with relapsing multiple sclerosis with chronic demyelinating optic neuropathy on stable immunomodulatory therapy. Patients who fulfilled international panel criteria for diagnosis with disease duration of less than 15 years were eligible. Patients were randomly assigned (1:1) via block randomisation using a random number generator to receive either clemastine fumarate (5·36 mg orally twice daily) for 90 days followed by placebo for 60 days (group 1), or placebo for 90 days followed by clemastine fumarate (5·36 mg orally twice daily) for 60 days (group 2). The primary outcome was shortening of P100 latency delay on full-field, pattern-reversal, visual-evoked potentials. We analysed by intention to treat. The trial is registered with ClinicalTrials.gov, number NCT02040298.
  
  Findings: Between Jan 1, 2014, and April 11, 2015, we randomly assigned 50 patients to group 1 (n=25) or group 2 (n=25). All patients completed the study. The primary efficacy endpoint was met with clemastine fumarate treatment, which reduced the latency delay by 1·7 ms/eye (95% CI 0·5–2·9; p=0·0048) when analysing the trial as a crossover. Clemastine fumarate treatment was associated with fatigue, but no serious adverse events were reported.
  
  Interpretation: To our knowledge, this is the first randomised controlled trial to document efficacy of a remyelinating drug for the treatment of chronic demyelinating injury in multiple sclerosis. Our findings suggest that myelin repair can be achieved even following prolonged damage.
  
  Funding: University of California, San Francisco and the Rachleff Family.
  
  Free full text.

Researching this for my son a while ago, I found this is no longer an OTC drug. (How convenient.) The potential for Clemastine fumarate as a treatment for MS has been investigated for a number of years and this would not be the first study to suggest its efficacy at remyelination. It appears it was pulled from the market as an antihistamine after its potential to treat MS was discovered. I even contacted Sandoz/Novartis (which, at the time, still marketed it for cats and dogs as an antipruritic) to see if that product was safe for human consumption. They replied with an email with only a phone number to call, and the call was of no help. If I am mistaken, and this is still on the market for people, can someone let me know? Many who took it for allergies are disappointed they can no longer obtain it. It had fewer side effects than most other allergy meds.

In Europe (or some regions at least) it is being sold under the Tavegyl brand. It is an OTC drug produced by GlaxoSmithKline.

Hi,

The first thing to do is look up the medication and see what it does. It's an anticholinergic. That means it blocks the neurotransmitter aceytlcholine. As a consequence, you are influencing the autonomic immune system, in particular, the parasympathetic pathways controlling smooth muscle action. Aceytlcholine also plays a role in the early signalling for some of adrenergic pathways where other neurotranmitters called monoamines have primary responsibility (Dopamine, Epinephrine(noradrenaline), Epinephrine (adrenaline),Histamine and many others).
Aceytlcholine is the neurotransmitter that signals skeletal muscles. It is actually a very big leap of faith to interfere with that. Our problems with spasticity are probably further down the chain in that pathway where calcium homeostasis is disregulated.

Have a read about the recreational use of anticholinergics in this link https://en.wikipedia.org/wiki/Anticholinergic .

Perhaps at your autopsy they will admire how your myelin grew back but I won't go near that idea.

Regards,

Scott1 wrote:The first thing to do is look up the medication and see what it does. It's an anticholinergic. That means it blocks the neurotransmitter aceytlcholine. As a consequence, you are influencing the autonomic immune system, in particular, the parasympathetic pathways controlling smooth muscle action. Aceytlcholine also plays a role in the early signalling for some of adrenergic pathways where other neurotranmitters called monoamines have primary responsibility (Dopamine, Epinephrine(noradrenaline), Epinephrine (adrenaline),Histamine and many others).
Aceytlcholine is the neurotransmitter that signals skeletal muscles. It is actually a very big leap of faith to interfere with that. Our problems with spasticity are probably further down the chain in that pathway where calcium homeostasis is disregulated.

There's also a risk of memory loss and dementia.

Be wary of anticholinergic sleep aid medications.

• Did Popular PM Pain Reliever Trigger Memory Loss?
  
  Millions of Americans worry about memory loss. They never think to link an OTC drug they take to get to sleep as contributing to brain fog. Is it a risk?
  https://www.peoplespharmacy.com/2016/11 ... mory-loss/
  
  
• Where Can I Find A List of Anticholinergic Drugs?
  
  People taking anticholinergic drugs over a long period of time may be at greater risk of developing dementia.
  https://www.peoplespharmacy.com/2017/05 ... gic-drugs/
  
  
• Are My Medications Causing Me Memory Problems?
  
  Do you know if your medicine has anticholinergic activity that could be affecting your brain and causing memory problems? The list of drugs is quite large.
  https://www.peoplespharmacy.com/2016/06 ... -problems/

Clemastine is listed as having a moderate to high anticholinergic activity.

A lot of the info posted above is beyond me but in layman's terms, a major issue/side effect with Clemastine that was brought up at the seminar is that the drug causes drowsiness, an obvious no no for pwMS.

Here is some additional info about the speaker conducting the seminar:

http://profiles.ucsf.edu/jonah.chan

He is quite an accomplished Doctor/Researcher. Here is some basic info about him from his UCSF profile:

Dr. Jonah R. Chan received his BS in Biochemistry and PhD in Neuroscience at the University of Illinois at Urbana-Champaign. He completed a postdoctoral fellowship in the Department of Neurobiology at Stanford University with Dr. Eric Shooter. Jonah is currently the Debbie and Andy Rachleff Distinguished Professor of Neurology. He is a member of the Neuroscience Graduate Program and the MS Research Center at UCSF.

The Chan laboratory has a long-standing interest in fundamental glial/neuronal interactions and the molecular mechanisms that regulate myelination. Myelination is one of the most exquisite examples of cell-cell interaction found in nature and functions to maximize the efficiency and velocity of action potentials transmitted throughout the nervous system. While much has been learned about the global determinants that generate myelin-forming cells during development, the Chan laboratory is particularly interested in understanding how local environmental cues control the spatiotemporal regulation of differentiation and myelination, including both molecular and biophysical interactions. Identification of an environment that is conducive for myelination could have important implications for efforts aimed at promoting repair and remyelination in the nervous system.


Here is some additional info about his research:

http://jonahchanlab.com/about/

Cheer, glad the CCSVI worked for Jeff. The procedure helped me briefly( done by Dr S in Albany). If j knew what I know now, I wouldn't have done it. Repairing damage sounds like a better option, everything has sideffects including CCSVI.

" Repairing damage sounds like a better option"

This is true but there is little evidence that any treatment of any kinds really works (at this time).


" If I knew what I know now, I wouldn't have done it."

Can you elaborate?

Yes, please reply regarding having CCSVI in Albany with Dr. S. Do you mean Dr. Sclafani? In Albany, not Brooklyn. You wish you hadn't had it. I'm about to have it again. What were your side effects?

(Should this --also?--be in a different topic? I'm still new here. Can we move it appropriately?)