Modified Ketogenic Diet Therapy for Relapsing Multiple Sclerosis: Patient-Reported Outcomes (P3.2-044)

Objective: To report the multiple sclerosis (MS) patient experience after completion of a 6 month trial of a modified ketogenic diet.

Background: Dietary intake influences an individual’s immune profile and response. The impact of diet in MS is clinically meaningful, with evidence supporting an association between diet and disability. We have previously reported evidence of safety and adherence of ketogenic diets (KDs) in relapsing-remitting MS (RRMS) patients, with improvements in fatigue, depression, and disability metrics.

Design/Methods: Twenty patients with a diagnosis of RRMS were enrolled. Subjects were educated in-person by a trained dietitian on how to adhere to a modified KD (i.e. modified Atkins or KD^MAD). Adherence to diet was objectively monitored by daily urine ketone testing. Clinical and patient-reported outcome measures were obtained at baseline (pre-diet) and after 6 months of treatment. A patient-experience survey was completed at the time of diet trial completion.

Results: Of the 20 subjects enrolled at baseline, two subjects were lost to follow-up. From the remaining 18 subjects, over half had previously attempted a diet for their MS. Upon completing the 6 month trial of KD^MAD, 56% of subjects planned to continue on strict KD^MAD after trial completion. All 18 subjects would recommend KD^MAD to a colleague. The most common patient-perceived benefits of KD^MAD included weight loss (83%), improved fatigue (72%), improved exercise habits (55.5%), improved stamina (50%), and reduced MS symptoms (45%). The most common side effects experienced on KD^MAD included constipation (28%), menstrual irregularities (22%), and diarrhea (17%).

Conclusions: The KD^MAD is a feasible diet for RRMS patients and provides multiple patient-perceived benefits that are clinically-relevant to MS subjects. As the majority of our subjects plan to continue on KD^MAD, longitudinal clinical and laboratory data collection is ongoing.

Disclosure: Dr. Brenton has nothing to disclose. Dr. Banwell has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Novartis. Dr. Bergqvist has nothing to disclose. Dr. Lehner-Gulotta has nothing to disclose. Dr. Gampper has nothing to disclose. Dr. Leytham has nothing to disclose. Dr. Goldman has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with EMD Serono, Celgene, Sanofi Genzyme, Novartis Pharmaceutical, RxMx, and Teva Neuroscience. Dr. Goldman has received research support from MedDay, Novartis , NIH, National MS Society, and PCORI.