Intranasal Insulin for Improving Cognitive Function in Multiple Sclerosis

Abstract

Cognitive dysfunction is common and devastating to people with multiple sclerosis (MS). To date, multiple pharmacologic interventions have been tried for MS-related cognitive dysfunction with disappointing results. Hence, there is an urgent need to identify or develop novel therapies that can help improve cognitive function in MS. This clinical trial is designed to evaluate the safety, tolerability, and efficacy of intranasal insulin in cognitively impaired people with MS. The study will also evaluate the impact of intranasal insulin on measures of oxidative stress, axonal injury, cellular stress, and energy metabolism in MS. The design of this phase I/II, randomized, double-blind, placebo-controlled trial is as follows; 105 participants will be randomized (1:1:1, stratified by relapsing versus progressive MS) to intranasal insulin 10 international units (IU) twice a day, 20 IU twice a day, or placebo for 24 weeks. Insulin will be administered intranasally to allow direct delivery of the medication into the central nervous system. Standardized cognitive assessments will occur at baseline and throughout the 24-week trial, as well as for a period of 24 weeks after discontinuation of the intervention, to evaluate the impact of insulin on cognitive performance as well as the longevity of the treatment response. If intranasal insulin does appear to be safe and shows some evidence of helping cognition in MS, we will pursue a larger clinical trial to confirm our results. Intranasal insulin may provide a safe way to improve cognition and, ultimately, overall disability in people with MS, leading to better quality of life for patients and their caregivers.

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Document Details

Document Type
Technical Report
Publication Date
Oct 01, 2019
Accession Number
AD1095369

Entities

People

  • Ama Avornu
  • Ellen M Mowry
  • Pablo Ravenna
  • Scott Newsome

Organizations

  • Johns Hopkins University

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Central Nervous System
  • Clinical Trials
  • Cognition
  • Cognitive Impairment
  • Diseases And Disorders
  • Health Services
  • Logistics Planning
  • Management Personnel
  • Medical Personnel
  • Mental Processes
  • Metabolism
  • Multiple Sclerosis
  • Nervous System
  • Oxidative Stress
  • Personnel Management
  • Sclerosis
  • Training

Fields of Study

  • Medicine
  • Psychology

Readers

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