Aspirin May Be an Effective Pretreatment for Exercise in Patients With MS

LOS ANGELES—Aspirin may be an effective pretreatment for exercise in patients with multiple sclerosis (MS), according to a study described at the 70th Annual Meeting of the American Academy of Neurology.

“Exercise in MS we know to be beneficial on multiple levels,” said Victoria M. Leavitt, PhD, Assistant Professor of Neuropsychology at Columbia University Medical Center in New York. “In addition to physical benefits like gait, balance, and improved cardiovascular fitness, exercise is also associated with improved mood, reduced fatigue, and improved memory performance. The challenge, of course, is that exercise is only beneficial if people actually do it.”

Victoria M. Leavitt, PhD

Exercise-induced overheating, exhaustion, and symptom worsening (Uhtoff’s phenomenon) deter many patients with MS from exercise, and patients may have elevated resting body temperatures that are associated with worse fatigue.

To test whether aspirin pretreatment improves exercise performance in people with MS, Dr. Leavitt and colleagues conducted a randomized, placebo-controlled, crossover pilot study. The researchers studied aspirin because of its antipyretic effects and its efficacy in reducing fatigue in nonexercising patients with MS. The primary outcome was total time spent exercising. Change in exercise-induced body temperature was a secondary outcome.

In all, 12 patients participated in the study (nine females; mean age, 39.8; mean disease duration, 7.7 years; Expanded Disability Status Scale scores of 6.5 or less). Eight patients reported heat sensitivity during exercise.

Participants completed two maximal progressive ramped lower body cycle ergometer exercise tests one week apart after taking 650 mg of aspirin or placebo one hour before each test.

Patients exercised an average of 16.4 seconds longer after taking aspirin (9 minutes 28.6 seconds), versus placebo (9 minutes 12.2 seconds). In heat-sensitive patients, average body temperature increase after exercise with aspirin (0.41°F) was lower than the increase with placebo (0.88°F). This difference was not statistically significant.

Larger studies are needed, but the results are encouraging, Dr. Leavitt said. “The next thing we want to look at is how this translates to everyday exercise,” she said. “Does aspirin use in people with MS result in increased physical activity levels or increased adherence to exercise regimens?”

—Jake Remaly

Suggested Reading

Leavitt VM, Blanchard AR, Guo CY, et al. Aspirin is an effective pretreatment for exercise in multiple sclerosis: a double-blind randomized controlled pilot trial. Mult Scler. 2017 Oct 27 [Epub ahead of print].

Wingerchuk DM, Benarroch EE, O’Brien PC, et al. A randomized controlled crossover trial of aspirin for fatigue in multiple sclerosis. Neurology. 2005;64(7):1267-1269.