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Medium-term carnosine supplementation positively affects patient-reported outcomes in multiple sclerosis

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Abstract

Multiple sclerosis (MS) is a potentially disabling autoimmune disease of the central nervous system, with a rather uncertain prognosis and no cure. Supplemental carnosine seems to be beneficial for balancing contractile function and reducing fatigue while these functions are altered in MS; however, the effects of carnosine as an element of management of MS remain unclear. PURPOSE: In this preliminary study, we evaluated the effects of medium-term carnosine administration on Multidimensional Fatigue Inventory (MFI) and Short Form Survey Instrument (SF-36) in adult patients with MS. METHODS: During 2018 (from March to November) 51 patients with MS (age 44.9 ± 8.4 years; 15 men and 36 women) were recruited and examined by a certified health care professional. All patients were allocated to an open-label treatment trial with supplemental carnosine (500mg/day) administered during the four months, with patients evaluated at baseline and at post-intervention follow-up. RESULTS: A total MFI score dropped after carnosine intervention (64.1 ± 19.1 at baseline vs. 52.5 ± 19.1 at follow-up; P < 0.05), indicating reduced self-reported fatigue for 18.1% in patients suffering from MS. This was accompanied by improved SF-36 scores for 14.5% at 4-month follow-up. CONCLUSION: Supplemental carnosine is effective in reducing fatigue in mid-age patients with MS.
Medium-Term Carnosine Supplementation Positively
Affects Patient-Reported Outcomes in Multiple Sclerosis
ABSTRACT
Multiple sclerosis (MS) is a potentially disabling autoimmune disease of the central nervous system, with a rather uncertain prognosis and no cure. Supplemental
carnosine seems to be beneficial for balancing contractile function and reducing fatigue while these functions are altered in MS; however, the effects of carnosine as an
element of management of MS remain unclear. PURPOSE: In this preliminary study, we evaluated the effects of medium-term carnosine administration on
Multidimensional Fatigue Inventory (MFIS) and Short Form Survey Instrument (SF-36)in adult patients with MS.METHODS: During 2018 (from March to November) 51
patients with MS (age 44.9 ±8.4 years; 15 men and 36 women) were recruited and examined by a certified health care professional. All patients were allocated to an
open-label treatment trial with supplemental carnosine (500mg/day) administered during the four months, with patients evaluated at baseline and at post-intervention
follow-up.RESULTS: A total MFI score dropped after carnosine intervention (64.1 ±19.1 at baseline vs.52.5 ±19.1 at follow-up;P< 0.05), indicating reduced self-
reported fatigue for 18.1% in patients suffering from MS. This was accompanied by improved SF-36 scores for 14.5% at 4-month follow up.CONCLUSION: Supplemental
carnosine is effective in reducing fatigue in mid-age patients with MS.
Figure 2. Total SF-36 score at baseline and at each follow-up visit. Values are mean ±SD.
Jasna SIMICIC, Sergej M. OSTOJIC
Applied Bioenergetics Lab, University of Novi Sad, Serbia
Figure 1. Changes in total MFI score and MFI subscales during the study.
Values are mean ±SD.
THIS STUDY WAS PARTIALLY SUPPORTED BY CARNOMED LLC, NOVI SAD 21000, SERBIA | www.carnomed.com
Background
Multiple sclerosis (MS) is a prevalent inflammatory-demyelinating disease, with
fatigue and impaired quality of life often reported among key MS pathognomonics.
Supplemental L-carnosine (dipeptide composed of beta-alanine and L-histidine)
could be effective in reducing fatigue and improving quality of life in MS patients due
to its antioxidative, anti-carbonylating, anti-glycation, neuroprotective and chelating
properties yet no human trial evaluated this hypothesis.
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Methods
In this open-label interventional preliminary study, 51 MS patients aged 20 to 65
years received oral L-carnosine formulation (500 mg per day b.i.d.) during 4 months;
most of the patients (83.0%) had relapsing-remitting MS.At baseline and at each
month follow-up visits, patients completed two questionnaires: (1) Multidimensional
Fatigue Inventory (MFI), a 20-item self-report instrument designed to measure
fatigue; and (2) Short Form Survey Instrument (SF-36), patient-reported survey of
patient health.
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Results
Compliance with the intervention (determined by capsule counts at final visit) was
high (88.0 ±11,4%). Total MFI score improved from 52.5 ±19.1 at baseline to 64.1 ±
19.1 at 4-month follow-up (P< 0.05) (Figure 1). MFI subscales analysis revealed a
significant change for cognitive and physical domain after an intervention (P< 0.05).
This was accompanied by improved SF-36 scores for 14.5% at 4-month follow up
(Figure 2).
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Conclusion
Medium-term supplementation with L-carnosine resulted in a significant fatigue
reduction and improved health-related quality of life in men and women suffering
from MS, while a treatment protocol was well tolerated. Therefore, oral L-carnosine
may become an important adjuvant to the pharmacological therapeutics available
for the management of MS-related fatigue and quality of life.Long-term well-
sampled studies are highly warranted to confirm these preliminary results.
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