Abstract: FR-PO0803
Lipoic Acid Supplementation Is Associated with Proteinuria in a Randomized Controlled Trial of Patients with Progressive Multiple Sclerosis
Session Information
- Glomerular Clinical Trials: From Data to Impact
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Stanaway, Madison, Oregon Health & Science University School of Medicine, Portland, Oregon, United States
- McNee, Caroline, Oregon Health & Science University School of Medicine, Portland, Oregon, United States
- Waslo, Carin Stewart, Portland VA Medical Center, Portland, Oregon, United States
- Struthers, Hillary, Oregon Health & Science University School of Medicine, Portland, Oregon, United States
- Hildebrand, Andrea D, Oregon Health & Science University School of Medicine, Portland, Oregon, United States
- Spain, Rebecca, Portland VA Medical Center, Portland, Oregon, United States
- Avasare, Rupali S., Oregon Health & Science University School of Medicine, Portland, Oregon, United States
Background
Lipoic acid (LA), an over-the-counter dietary supplement, has been linked to NELL1 membranous nephropathy (MN) through small case series. In a recent multicenter placebo-controlled randomized controlled trial (RCT) of LA for progressive multiple sclerosis (MS), standardized urine collection was added to safety lab monitoring due to the discovery of proteinuria in several subjects. Full results from the trial are available for 112 participants (53 LA, 59 placebo). We aim to analyze the association between LA use and proteinuria development in a RCT.
Methods
Participants were grouped by use of LA or placebo. The presence of proteinuria and GFR was documented in both groups at pre-specified intervals. Number of participants in each group with proteinuria and abnormal GFR results (defined as decline of ≥25% from baseline or GFR<60 at any visit post-baseline) were compared by chi-square tests.
Results
We found that 36% (n=19) of the LA arm developed proteinuria vs 8% (n=5) in the placebo arm (p=0.001). Also, 21% (n=11) of the LA arm experienced an abnormal GFR vs 14% (n=8) of the placebo arm (p=0.447). The Month 3 visit had the highest number of participants with onset of proteinuria, with 8 subjects in the LA arm (4 with grade 1 and 4 with grade 2) and 4 in the placebo arm (2 with grade 1 and 2 with grade 2). Two of 3 subjects with nephrotic-range proteinuria in the LA arm underwent kidney biopsies and were diagnosed with NELL1 MN.
Conclusion
This is the first RCT that suggests an association between LA and proteinuria but not GFR. This is foundational knowledge about the potential risks of over-the-counter LA use, particularly in the MS population.
Funding
- NIDDK Support