Propionic Acid for Multiple Sclerosis: Safety and Benefits

Propionic Acid in Multiple Sclerosis: Safety, Tolerability and Clinical Outcomes From the Pro-MADAI Study

The purpose of this study is to explore the long-term safety, tolerability, and clinical efficacy of propionic acid as an add-on therapy in multiple sclerosis (MS).

This study is a prospective, open-label extension of the placebo-controlled MADAI trial, including 22 patients with stable relapsing-remitting multiple sclerosis. Participants received oral PA (500 mg twice daily) for an additional 9 months follow-up (FU). Multimodal assessments included cognitive testing (SDMT), physical performance (9HPT, 10mWT), patient-reported outcome measurements PROMs (SF-36, FSMC, ESS, BDI-II), and serum NfL analysis.

Inclusion Criteria:

• Diagnosis of multiple sclerosis (MS)
• Clinically and radiologically stable MS in the previous 3 months
• Age between 18 and 70 years
• Positive finding for oligoclonal bands (OCBs)
• Written consent
• Blood collection at the beginning and end of the study for routine parameter examination as well as sample preservation (especially for measuring propionic acid levels)
• Negative pregnancy test for female participants of childbearing age

Exclusion Criteria:

• History of ongoing propionic acid (PA) supplementation exceeding 3 months
• Positive JC virus titer during natalizumab treatment
• Presence of severe active systemic disease
• Presence of acute neurological conditions