Pharmacokinetic study of acid in multiple sclerosis: Comparing mice and human pharmacokinetic parameters

Lipoic acid is a natural anti-oxidant available as an oral supplement from a number of different manufacturers. Lipoic acid administered subcutaneously is an effective therapy for murine experimental autoimmune encephalomyelitis, a model of multiple sclerosis. The aim of this study was to compare serum lipoic acid levels with oral dosing in patients with multiple sclerosis with serum levels in mice receiving subcutaneous doses of lipoic acid. We performed serum pharmacokinetic studies in patients with multiple sclerosis after a single oral dose of 1200mg lipoic acid. Patients received one of the three different racemic formulations randomly: tablet (Formulation A) and capsules (Formulations B and C). Mice pharmacokinetic studies were performed with three different subcutaneous doses (20, 50 and 100 mg/kg racemic lipoic acid). The pharmacokinetic parameters included Maximum Serum Concentrations (C _max in μg/ml) and area under the curve_0-infinity (AUC_0-infinity in ng^*min/ml). We found mean C _max and AUC_0-infinity in patients with multiple sclerosis as follows: group A (N = 7) 3.8 ± 2.6 and 443.1 ± 283.9; group B (N = 8) 9.9 ± 4.5 and 745.2 ± 308.7 and group C (N = 8) 10.3 ± 3.8 and 848.8 ± 360.5, respectively. Mean C_max and AUC_0-infinity in the mice were: 100 mg/kg lipoic acid: 30.9 ± 2.9 and 998 ± 245; 50 mg/kg lipoic acid: 7.6 ± 1.4 and 223 ± 20; 20 mg/kg lipoic acid: 2.7 ± 0.7 and 119 ± 33. We conclude that patients taking 1200 mg of lipoic acid from two of the three oral formulations achieved serum C_max and AUC levels comparable to that observed in mice receiving 50 mg/kg subcutaneous dose of lipoic acid, which is a highly therapeutic dose in experimental autoimmune encephalomyelitis. A dose of 1200mg oral lipoic acid can achieve therapeutic serum levels in patients with multiple sclerosis.