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Clemastine may promote remyelination of optic nerve

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Results of a small study suggest that clemastine, a drug used to treat allergies, may repair damage to myelin in the optic nerve of people with MS.

The phase II trial, which has just been published in the Lancet, involved 50 people with relapsing remitting MS with evidence of long term damage to the optic nerve.

The study used visual evoked potentials to measure the speed at which nerve impulses travelled from the eye to the visual cortex at the back of the brain. When the myelin coating of the optic nerve is damaged, the nerve impulse is slowed down.

Treatment with clemastine resulted in a small improvement in the speed of the nerve impulse. The researchers interpret this as showing repair to the damaged myelin coating of the optic nerve. The results suggest an improvement in vision, but the numbers involved were too small for this to be conclusive. The researchers were unable to show the repair on MRI scans and other measures of myelin.

Clemastine treatment was associated with fatigue, but no serious side effects were reported.

The dose used in the study was larger than normally used for allergies.

The researchers warn that more research with larger numbers of people is needed to better understand the role clemastine may play as a treatment for people with MS.

More references

  • Green AJ, et al. Clemastine fumarate as a remyelinating therapy for multiple sclerosis (ReBUILD): a randomised, controlled, double-blind, crossover trial Lancet 2017; Oct 10:1-9 [Epub ahead of print] Read the full paper

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