Effect of combination of glucocorticoid and different doses of atorvastatin on neural function, blood lipid levels and magnetic resonance imaging in patients wit h multiple sclerosis

Abstract

Purpose: To determine the efficacy of the combination of glucocorticoid and different doses of atorvastatin in the treatment of patients with multiple sclerosis (MS). Methods: Sixty MS patients treated at Heping Hospital Affiliated to Changzhi Medical College from January 2020 to June 2021, were equally and randomly assigned to study group (OG) and control group (CG). Patients in OG were treated with glucocorticoid and atorvastatin (half in low-dose, LDG; 20 mg/day) and the other half, in high-dose atorvastatin (HDG, 40 mg/day)). Patients in CG were treated with glucocorticoid and placebo. Changes in magnetic resonance imaging (MRI), blood lipids, RhoA, and neural function were determined. Results: After treatment, Expanded Disability Status Scale (EDSS) score was lower in HDG than in LDG and CG (p < 0.05). Total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), triglycerides (TG) and lipoprotein a (LP(a)) were significantly reduced and followed the rank order: HDG < LDG < CG (p < 0.05). No appreciable differences occurred in HDL-C levels amongst HDG, LDG and CG (p > 0.05). Furthermore, RhoA levels were lower in HDG than in LDG and CG, with lower levels in LDG than in CG (p < 0.05). There were lower numbers of T2 lesions in HDG than in LDG and CG at 28 days, 3, 6 and 12 months, post-treatment (p < 0.05). Conclusion: Glucocorticoid and high-dose atorvastatin combination is better at reducing neurological dysfunction and improving blood lipid indicators in MS patients. This finding may provide a useful guide in the determination of the optimal dose of atorvastatin.