Multiple system atrophy (MSA) is a neurological disorder that affects the body’s involuntary actions. The polyphenol epigallocatechin gallate is an inhibitor of α-synuclein aggregation, which may lead to slow disease progression in patients with MSA. This study aims to assess the efficacy and safety of epigallocatechin gallate in patients with MSA. 

This is a randomized, double-blind, parallel-group, placebo-controlled clinical trial conducted at 12 specialist centers in Germany. The study included a total of 92 participants aged 30 years and more, who met consensus criteria for possible or probable MSA. The participants were randomly assigned to epigallocatechin gallate (n=47) or placebo (n=45). The primary outcome was the change in motor examination score of UMSARS from baseline to 52 weeks. 

Out of 92 participants, 64 completed the study. No significant mean change from baseline to week 52 in motor examination scores on UMSARS was recorded between the epigallocatechin gallate and the placebo groups. Four participants in the epigallocatechin gallate group and two in the placebo group died, and two patients in the epigallocatechin gallate group had to stop treatment due to hepatotoxicity.

The research concluded that long-term epigallocatechin gallate treatment was not associated with slower disease progression in patients with MSA. Epigallocatechin gallate was well-tolerated but caused hepatotoxicity in some patients.