A randomized controlled phase II trial of riluzole in early multiple sclerosis

Emmanuelle Waubant, Amir Hadi Maghzi, Nisha Revirajan, Rebecca Spain, Laura Julian, Ellen M. Mowry, Jacqueline Marcus, Shuang Liu, Chengshi Jin, Ari Green, Charles E. McCulloch, Daniel Pelletier

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Objectives: We evaluated the effect of riluzole versus placebo added to weekly IM interferon beta-1a in early multiple sclerosis (MS). Methods: This is a randomized (1:1), double-blind, placebo-controlled trial of riluzole 50 mg twice daily in subjects with MS onset less than 1 year prior. Trial participation was up to 3 years. The primary endpoint was change in percent brain volume change. Secondary endpoints included changes in normalized gray and normal-appearing white matter volumes, retinal nerve fiber layer thickness (RNFL), MS Functional Composite and Symbol Digit Modalities Test scores. Mixed model regression analysis was used to compare the changes over time between groups. Results: Forty-three subjects were randomized to study drug (22 riluzole, 21 placebo). Baseline characteristics were overall similar between groups except for older age (P = 0.042), higher normalized cerebrospinal fluid volume (P = 0.050), lower normalized gray matter volume (P = 0.14), and thinner RNFL (P = 0.043) in the riluzole group. In the primary analysis, percent brain volume change in the placebo group decreased at a rate of 0.49% per year whereas the riluzole group decreased by 0.86% per year (0.37% more per year; 95% CI −0.78, 0.024; P = 0.065). Although age did not influence the rate of brain volume decline, the difference between groups was attenuated after adjustment for baseline normalized gray matter and lesion volume (0.26% more per year in riluzole group; 95% CI −0.057, 0.014; P = 0.22). Analyses of secondary outcomes showed no differences between groups. Interpretation: This trial provides class 1 evidence that riluzole treatment does not meaningfully reduce brain atrophy progression in early MS.

Original languageEnglish (US)
Pages (from-to)340-347
Number of pages8
JournalAnnals of Clinical and Translational Neurology
Volume1
Issue number5
DOIs
StatePublished - May 2014

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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    Waubant, E., Maghzi, A. H., Revirajan, N., Spain, R., Julian, L., Mowry, E. M., Marcus, J., Liu, S., Jin, C., Green, A., McCulloch, C. E., & Pelletier, D. (2014). A randomized controlled phase II trial of riluzole in early multiple sclerosis. Annals of Clinical and Translational Neurology, 1(5), 340-347. https://doi.org/10.1002/acn3.60