Mixed-amphetamine salts, extended release for cognitive impairment in persons with MS, a randomized controlled trial.
Sarah A Morrow, Heather Rosehart, Penelope Smyth et al.
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In 30 seconds
This double-blind, placebo-controlled, multicentre randomised trial assessed extended-release mixed-amphetamine salts (MAS-XR) for cognitive impairment in people with multiple sclerosis who had impaired Symbol Digit Modalities Test (SDMT) scores. Participants were assigned to 10 mg MAS-XR, 20 mg MAS-XR, or placebo for 12 weeks; 109 of 123 randomised participants completed the study. At 12 weeks, SDMT scores did not differ significantly between groups (p = 0.545), nor between placebo and the combined MAS-XR groups (p = 0.945). The authors concluded that the findings do not support MAS-XR for cognitive impairment or information processing speed in this population.
Key findings
- At 12 weeks, SDMT scores showed no significant difference among groups (p = 0.545).
- Comparing placebo with both MAS-XR groups combined also showed no significant SDMT difference (p = 0.945).
- MFIS-cognitive and MFIS-psychosocial scores differed significantly over 12 weeks (both p = 0.018).
- SF-36 differed significantly for the 20 mg MAS-XR group versus placebo (p = 0.041).
Why it matters
Cognitive impairment and slowed information processing are common concerns in multiple sclerosis, but this trial found no improvement on its primary cognitive measure with either MAS-XR dose. The secondary questionnaire findings indicate differences in some reported outcomes, but they do not overturn the null primary result. The study therefore adds controlled evidence to inform assessment of this proposed pharmacological approach.
What to keep in mind
The study lasted 12 weeks, and the groups were not well matched on age, which was included as a covariate in the analysis.