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Pregnancy hormone estriol
Reduces MS Lesions in Small Study
Medical Update Memo
October 21, 2002
Summary
A small (12 person) study of the hormone estriol found that
it decreased MRI-detected brain lesion activity and immune responses
in women with relapsing-remitting MS. The study suggests that
additional study of estriol, a hormone which is elevated in
the later stages of pregnancy, is warranted to determine long-term
effectiveness and safety. The study was headed by Dr. Rhonda
Voskuhl, University of California at Los Angeles.
Details
It has been previously observed that women with MS and who are
pregnant have fewer MS symptoms and MS relapses in the second
and third trimester of pregnancy. The hormone estriol is elevated
during this time period. Studies with mice given pregnancy-levels
of estriol found they had fewer symptoms of the animal model
for MS.
In this small pilot study headed by Dr. Rhonda
Voskuhl, University of California at Los Angeles, 12 women were
given 8 mg of estriol in pill form every day for six months.
Six of the women had relapsing-remitting MS (experiencing acute
attacks followed by partial or total recovery) and six had secondary-progressive
MS (steadily worsening disease that often occurs following the
relapsing course).
All received monthly MRI scans and immunologic tests every six
months.
Estriol was found to be well tolerated by
both groups with only menstrual cycle abnormalities. The six
participants with relapsing-remitting MS experienced statistically
significant decreases in MS brain lesions and volume as measured
by MRI as well as a reduction in levels of immune proteins indicative
of inflammation. When estriol treatment was stopped, lesion
numbers returned to pre-treatment levels, and decreased again
when estriol treatment was resumed. During the treatment periods,
cognitive function scores improved in the relapsing-remitting
group. The six women with secondary-progressive MS did not improve
significantly during the course of the study.
Conclusions
This small study of pregnancy levels of estriol suggests that
short-term use is well tolerated and that larger, longer-term
clinical trials are warranted in women with relapsing-remitting
MS to determine if these preliminary, encouraging findings would
continue. A larger study is in the planning stages.
Safety considerations will be important in
any future study. This summer a clinical trial involving estrogen
and progesterone in healthy, post-menopausal women was stopped
because of a higher than expected risk of breast cancer, heart
attack and stroke.
With Information from the National MS Society
(USA)
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Disclaimer
The Multiple Sclerosis Society of Canada is an independent,
voluntary health agency and does not approve, endorse or recommend
any specific product or therapy but provides information to
assist individuals in making their own decisions.
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