High-dose biotin in progressive multiple sclerosis: A prospective study of 178 patients in routine clinical practice

Mult Scler. 2020 Dec;26(14):1898-1906. doi: 10.1177/1352458519894713. Epub 2019 Dec 17.

Abstract

Background: A recent controlled trial suggested that high-dose biotin supplementation reverses disability progression in patients with progressive multiple sclerosis.

Objective: To analyze the impact of high-dose biotin in routine clinical practice on disability progression at 12 months.

Methods: Progressive multiple sclerosis patients who started high-dose biotin at Nantes or Rennes Hospital between 3 June 2015 and 15 September 2017 were included in this prospective study. Disability outcome measures, patient-reported outcome measures, relapses, magnetic resonance imaging (MRI) data, and adverse events were collected at baseline, 6, and 12 months.

Results: A total of 178 patients were included. At baseline, patients were 52.0 ± 9.4 years old, mean Expanded Disability Status Scale (EDSS) score was 6.1 ± 1.3, mean disease duration was 16.9 ± 9.5 years. At 12 months, 3.8% of the patients had an improved EDSS score. Regarding the other disability scales, scores either remained stable or increased significantly. In total, 47.4% of the patients described stability, 27.6% felt an improvement, and 25% described a worsening. Four patients (2.2%) had a relapse. Of the 74 patients (41.6%) who underwent an MRI, 20 (27.0%) had new T2 lesions, 8 (10.8%) had gadolinium-enhancing lesions. Twenty-five (14%) reported adverse event.

Conclusion: In this study, high-dose biotin did not seem to be associated with a clear improvement in disability.

Keywords: Biotin; effectiveness; multiple sclerosis; primary progressive multiple sclerosis; progression; secondary progressive multiple sclerosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biotin
  • Disability Evaluation
  • Disease Progression
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Multiple Sclerosis* / drug therapy
  • Multiple Sclerosis, Chronic Progressive* / diagnostic imaging
  • Multiple Sclerosis, Chronic Progressive* / drug therapy
  • Multiple Sclerosis, Relapsing-Remitting*
  • Prospective Studies

Substances

  • Biotin