High Dose Biotin as Treatment for Progressive Multiple Sclerosis (P3.039)

Abstract

Objective: To determine the efficacy and tolerability of high dose biotin in persons with progressive MS. Background: High doses of biotin are reported to improve neurologic function in a small percentage of persons with progressive MS. We wished to document these potential benefits in a “real world” MS specialty clinic. Design/Methods: Three groups of patients with clinically definite multiple sclerosis were evaluated, those with relapses well controlled on disease-modifying therapy yet having progressive disability, patients with secondary progressive MS, no longer on disease-modifying therapy, and patients with primary progressive multiple sclerosis. High dose, pharmaceutical grade biotin, in 300 mg capsules, was prepared by a compounding pharmacy, One capsule per day was prescribed. Neurologic exams and blood work monitoring for toxicity were obtained at baseline and at three-month intervals on drug. Brain MRIs were obtained at baseline and after one year on biotin. Results: Twenty one patients were treated, eleven with secondary progressive MS, four with primary progressive MS, and six patients with relapsing remitting MS. Ten patients were on various disease-modifying therapies. There were 10 males and 11 females, ranging in age from 41 to 74 years. EDSS scores ranged from 4 to 6.5. To date, no patient experienced an adverse event. Of patients evaluated at three months, one patient’s EDSS improved from 6.5 to 6.0, with resolution of arthritic pain. One patient noted greatly improved energy with a 10[percnt] improvement in 25-foot timed walk. Data on all patients at nine-month and twelve-month exams will be presented. Conclusion: High dose biotin, administered daily to persons with progressive MS is well tolerated and results in improvement of neurologic function is a subset of such individuals.

Disclosure: Dr. Birnbaum received research support from Biogen-Idec and Hoffman-LaRoche. Dr. Stulc has nothing to disclose. Dr. Snyder has nothing to disclose.