High-dose biotin in multiple sclerosis:the end of the road

摘要

Since the first pilot study of high-dose biotin in patients with chronic progressive multiple sclerosis1 and the subsequent phase 2 randomised, double-blind, placebo-controlled trial (MS-SPI),2 biotin has been discussed as a potentially unique approach to treat progressive multiple sclerosis by targeting remyelination. Biotin, as a cofactor for four essential carboxylases, might support myelin repair by enhancing fatty acid synthesis and protect against hypoxia-driven axonal degeneration by augmenting energy production in neurons.1, 3