The objective of this study was to observe in real-life the biotin treatment in progressive MS in 5 MS centers from east France (Reims, Dijon, Strasbourg, Besançon, Nancy).

High-dose biotin can reverse MS-related disability in 12.6% of patient with progressive MS without recent inflammatory activity versus none of the placebo-treated patients in a 12-months controlled trial and with a maintained efficacy over 24 months.

Patients with progressive MS according to Mac Donald criteria from the 5 east France MS centers with a biotin treatment introduced between  the 1th October 2015 to the 1th october 2017 and followed with EDMUS were included.

Biotin was given for 579 progressive MS patients (376 with secondary progressive and 203 with primary progressive). The sex ratio (female/male) was to 1.6 (1.9 for SPMS, 1.2 PPMS). The mean age at biotin onset was of 57.1 +/- 10.1 years. The mean EDSS at the biotin onset was of 6.4 +/- 2.0. The mean delay between MS onset to biotin was of 24.5 +/-10.3 years for SPMS and 15 +/- 8.9 for PPMS. A concomitant DMT was given for 20.8% mostly for SPMS (25% versus 13% for PPMS).

The mean duration of biotin therapy was of 12.7+/-6.7 years for over all patients. The EDSS was improvement for 72 Patients (12,4%); without change for 397 (68,6%); with degradation for 110 (18,9%). No statistically significant difference was observed between SPMS and PPMS (p=0.39).

In real-life in 5 MS-centers, the benefit of biotin therapy in progressive MS seems comparable to the pivotal therapeutic trial with a proportion of good responders near 12.5% after one year of treatment.