Aspirin as a Pre-Treatment for Exercise in Multiple Sclerosis
Status:
Completed
Trial end date:
2017-05-10
Target enrollment:
Participant gender:
Summary
Exercise has many benefits for people with multiple sclerosis (MS), such as improved physical
symptoms, mood, fatigue, and cognition. However, many people with MS refrain from exercising
because of the discomfort of exhaustion and overheating that they experience. This study
investigates the use of aspirin before exercise as a treatment to reduce overheating and
exhaustion, thereby availing many more people with MS the opportunity to benefit from
exercise.
The investigators recently published the first-ever report of elevated body temperature in
relapsing-remitting MS (RRMS) patients relative to healthy controls, and elevated temperature
was linked to worse fatigue. This finding that body temperature is elevated and linked to
fatigue in RRMS lays the groundwork for a paradigm shift in our understanding and treatment
of fatigue. That is, the focus shifts from exogenous to endogenous temperature, and from
stimulant medication to cooling treatments.
A recent study comparing healthy adults to adults with MS showed that whereas exercise
increased body temperature in both groups, only in the MS group was it correlated with
exhaustion. The reason for this may relate to the elevation in resting body temperature in
relapsing-remitting MS (RRMS) patients relative to healthy controls. The finding is
clinically meaningful, as elevated body temperature was correlated with worse fatigue in
patients. Exercise Aim: To determine whether pretreatment with ASA (compared to placebo:
within subject crossover design) before exercise results in improved exercise performance
(i.e., increased time-to-exhaustion). The investigators hypothesize that participants will
tolerate exercise for longer after taking ASA than placebo. This hypothesis is based on a)
demonstrated efficacy of antipyretic for reducing body temperature during exercise in healthy
controls, b) demonstrated efficacy of antipyretic for reducing fatigue in non-exercising MS
patients, and c) demonstrated efficacy of elaborate (unblinded) cooling treatments (e.g.,
cooling garments, cooling hand chamber) for improving exercise performance in MS patients.
Note that this project is especially important for MS patients, who have a disease-specific
body temperature elevation and sensitivity to heat (i.e., Uhthoff's).