MS Speaks
Multiple Sclerosis => MS - RESEARCH AND NEWS => Topic started by: agate on April 29, 2018, 04:02:32 pm
-
A small study but one funded by the National MS Society, and its idea is so novel--and so comparatively easy and inexpensive--that it might be worth noticing.
Abstract of platform presentation at annual AAN conference in Los Angeles (April 25, 2018):
A Randomized Controlled Pilot Trial of Aspirin to Improve Exercise Performance in Persons with Multiple Sclerosis
Victoria Leavitt1 , Adam Blanchard3 , Chu-Yueh Guo4 , Eva Gelernt3 , James Sumowski5 , Claire Riley2 , Joel Stein
1 Neurology, Columbia University Medical Center, 2 Columbia University Medical Center, 3 Columbia University, 4 New York Presbyterian Hospital, Columbia, 5 Mount Sinai Hospital
Objective:
To conduct a randomized, double-blind crossover design pilot trial of aspirin as a pretreatment to improve exercise performance in patients with multiple sclerosis (MS).
Background:
Exercise is only beneficial if people do it. Many MS patients are deterred from exercising by overheating and exhaustion (“Uhthoff’s phenomenon”). We tested aspirin, an antipyretic, to improve exercise performance and reduce exercise-induced body temperature increase in persons with MS.
Design/Methods:
Twelve MS patients participated. At enrollment, 8 of 12 participants reported heat-sensitivity. All participants completed two exercise sessions separated by one week. At each session, participants were administered a standard dose (650 mg) of aspirin or placebo. After one hour, participants performed a progressive ramped maximal exercise test (lower body cycle ergometer). Test was terminated when volitional exhaustion was reached. Paired samples t-tests were conducted to evaluate differences in time-to-exhaustion (TTE) (primary outcome) and change in body temperature from pre- to post-exercise between ASA and placebo (secondary outcome).
Results:
Exercise performance (TTE) improved after aspirin compared to placebo (mean difference=16.4± 23.7 seconds); t(11)=2.405, p=0.035 (Cohen’s d=1.45). In heat-sensitive patients, the effect of aspirin was larger: t(7)=3.321, p=0.013 (Cohen’s d=2.51). In the full sample, exercise-induced body temperature increase did not differ; in the heat-sensitive subgroup, there was a 56% reduction in body temperature increase after aspirin (mean increase= 0.41°F± 0.55) vs. placebo (mean increase= 0.88°F± 0.63); t(7)= -1.494, p=0.178 (Cohen’s d=1.13).
Conclusions:
Prior exercise work in MS has shown efficacy for obtrusive and/or non-standardizable cooling methods such as cold baths and vacuum hand-cooling chambers. Aspirin, selected for its antipyretic effect, is convenient, inexpensive, and readily available. Aspirin may represent an effective treatment that allows more people with MS access to the many benefits of exercise. These results warrant follow-up in a large-scale trial.
Study Supported by: NMSS PR-1503-03477