Clemastine Fumarate Partially Reverses Vision Loss From MS

By Floyd Arthur

A new study from the University of California San Francisco shows that the

antihistamine clemastine fumarate (Tavist) partially reverses vision loss associated

with relapsing–remitting MS. Led by Dr. Ari Green of the Multiple Sclerosis Center at

UCSF, the study compared the effects of clemastine fumarate to placebo in 50

participants with MS and persistent optic neuropathy.

The researchers will present their findings at the American Academy of Neurology's

68th Annual Meeting in Vancouver, British Columbia this week.

Optic Neuritis and MS

Vision changes and pain associated with optic neuritis are a common and early sign of

multiple sclerosis, and are often the first symptom for which MS sufferers seek medical

care. The most commonly experienced visual disturbances include red-green color

blindness, diplopia, and partial or complete blindness in one eye. These are usually

accompanied by eye pain exacerbated by eye movement, peripheral and central visual

field disturbances and diminished pupillary response to light.

Optic neuritis is caused by demyelinating inflammatory changes in the optic nerve. It is

the presenting symptom in about 20 percent of MS diagnoses and affects about 50

percent of all patients with MS.

Treatment with high-dose intravenous methylprednisolone followed by an oral

prednisone taper usually results in rapid resolution of symptoms, but has not proven to

be of benefit in long term recovery of visual acuity.

Clemastine Fumarate Shows Promise

All participants in the five-month long UCSF study had chronic stable optic neuropathy

with long-term loss of visual acuity. Average age of participants was 40 years, and the

average duration of MS symptoms was five years.

The researchers used visual evoked potential as a measure of vision loss; included study

participants had a minimum transmission delay of at least 118 milliseconds -- a

biomarker for myelin loss.

For the first three months of the study, participants were randomized to either clemastine fumarate

or placebo. For the second two months, the study groups were reversed.

At the end of the study, transmission delay in patients receiving clemastine fumarate

was reduced by slightly less than 2 milliseconds per patient in each eye. Although

modest, the improvements are considered an indicator of myelin regrowth. Said Dr.

Green, “This study is promising because it is the first time a drug has been shown to

possibly reverse the damage done by MS. Findings are preliminary,” he added, “but this

study provides a framework for future MS repair studies and will hopefully herald

discoveries that will enhance the brain's innate capacity for repair."

Clemastine fumarate is a H1 histamine agent.The major side effect experienced by study

participants was fatigue.

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