Table 1.

Summary of human studies on the effects of riboflavin on multiple sclerosis

Study date (Ref No)	Study type	Riboflavin dose, sample size, and duration of study	Clinical outcomes	Laboratory outcomes
Naghashpour et al, 2013 (12)	RCT	A total of 29 MS patients were enrolled. The treatment group received 10 mg/day riboflavin orally for 6 months	No significant differences in EDSS between the treatment and placebo groups	No significant differences between the treatment and placebo groups in terms of EGRAC, riboflavin deficiency levels by EGRAC category and serum homocysteine levels
Bisaga et al, 2011 (23)	RCT	A total of 94 patients with RRMS and SPMS in the acute phase. Group 1 (n=53) received cytoflavin (including 5 mg riboflavin as riboflavin mononucleotide) and basic treatment (trental and group B vitamins) and Group 2 (n=41) received basic treatment (trental and group B vitamins).	About 41.5% patients treated with cytoflavin and 34% patients receiving basic treatment did not need corticosteroids. Significant reduction of EDSS and improvement of cognitive function were observed in patients treated with cytoflavin, compared to the group that did not receive this drug.	Decrease in lipid peroxidation levels and content of antibodies to basic myelin protein was evident in patients treated with cytoflavin, compared with the group that did not receive this drug
Ghadirian et al, 1998 (24)	Case-Control	197 incident cases and 202 frequency- matched controls	A negative linear trend was evident between higher intake of riboflavin and risk of MS (<0.001)

MS, multiple sclerosis; EDSS, expanded disability status scale; RCT, randomized controlled trials; EGRAC, erythrocyte glutathione reductase activity coefficient; RRMS, relapsing-remitting MS; SPMS, secondary-progressive MS