Relapsing-remitting Multiple Sclerosis Clinical Trial
Official title:
A Double-Blind, Placebo Controlled Trial of Estriol Treatment in Women With Multiple Sclerosis: Effect on Cognition.
Approximately 50% of people diagnosed with Multiple Sclerosis (MS) will develop problems with cognition. Currently, there are no FDA-approved treatments targeting cognitive function in Multiple Sclerosis. This trial will ascertain whether treatment with an estrogen pill, used in combination with standard MS anti-inflammatory drugs, can improve cognitive testing as compared to treatment with a placebo pill in combination with standard anti-inflammatory drugs in women with MS.
Approximately 50% of people diagnosed with Multiple Sclerosis (MS) will develop problems with
cognition. Currently, there are no FDA-approved treatments for cognitive function in Multiple
Sclerosis. Multiple sclerosis relapses are known to be significantly decreased by
approximately 80% during late pregnancy. This disease improvement may be due to estriol, an
estrogen unique to pregnancy. Estriol blood levels go from undetectable levels prior to
pregnancy, increase during pregnancy and reach highest levels during late pregnancy. Further,
estrogen treatment has been shown to have favorable effects on cognition in animal models of
other neurological diseases. This proposal will establish whether oral treatment with
estriol, induces an improvement in cognitive functioning in subjects with multiple sclerosis
when used in combination with the major FDA-approved standard treatments for MS, (Betaseron®
(or Extavia®), Rebif®, Avonex®, Copaxone®, Gilenya®, Aubagio®, Tecfidera®, or Ocrevus®).
The combination of standard MS treatment plus estriol pill (8 mg per day) will be compared to
standard MS treatment plus placebo in a double-blinded fashion. The duration of treatment
will be one year and the primary outcome measure will be cognitive testing processing speed
ability.
Secondary outcomes will be improvement in other cognitive tests, brain MRIs, cognitive evoked
potentials, as well as relapse rates and disability measures (EDSS, 25 foot walk, 9 hole peg
test, low contrast visual acuity, MS Quality of Life, Modified Fatigue Impact Scale, Beck
Depression Inventory, Level of Activity using accelerometry). Safety measures (blood tests
and gynecologic evaluations) will also be followed. The overall goal of this study will be
the development of an oral treatment, estriol, to improve cognitive function in MS.
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