Evidence supporting the use of: Biotin
For the health condition: Multiple Sclerosis

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Biotin (vitamin B7) has been investigated as a potential treatment for progressive forms of Multiple Sclerosis (MS), particularly primary and secondary progressive MS. The rationale stems from biotin’s role as a coenzyme for carboxylases involved in energy metabolism and fatty acid synthesis, processes that are essential for myelin production and nerve function. Early pilot studies and a phase II open-label study suggested that high-dose biotin (300 mg/day) might improve disability in progressive MS patients, possibly by enhancing remyelination and neuronal energy production.

However, more robust evidence from randomized, double-blind, placebo-controlled trials has yielded mixed results. The pivotal SPI2 trial (2019), which included 642 patients with progressive MS, found no significant difference between high-dose biotin and placebo in the primary endpoint of disability improvement. Some secondary outcomes hinted at possible benefit, but these were not statistically persuasive. Additionally, some safety concerns have been raised, including reports of worsening or new-onset MS symptoms in a subset of patients taking high-dose biotin.

In summary, while there is a scientific rationale and moderate early-stage evidence supporting biotin use in progressive MS, high-quality large-scale trials have not confirmed its efficacy. Thus, the evidence rating is 2 out of 5, reflecting limited and inconsistent scientific validation. Biotin is not considered a standard or widely recommended treatment for MS at this time.

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