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Huge multiple sclerosis trial launches

Published: 17 April 2023

A huge trial to find new ways to treat progressive forms of multiple sclerosis (MS) has opened for participants in the UK. The 'Octopus' trial is funded by the MS Society and the NIHR.

The multi-arm, multi-stage platform trial is designed to transform the way we test treatments for progressive MS. Platform trials aim to speed up testing for new treatments. As a result, treatments can reach patients up to three times faster than through traditional trials.

The same approach has changed how doctors treat men with prostate cancer. Participants answered eight research questions about treatments over only 15 years. A traditional trial design would have taken 50 years or so.

MS is a lifelong condition that can cause various symptoms. These include problems with vision, movement and balance. For people living with MS, disability progression is caused by degeneration of nerves in the brain. This happens to everyone as we age, but faster in people with MS and other neurodegenerative conditions, such as Alzheimer’s and Parkinson’s. Yet there are no treatments that target this progression.

Ranking drugs and recruiting participants

Over several years, a group of experts, as well as people living with MS, reviewed and ranked potential treatments. Their focus was on drugs used for other conditions that have the potential to protect nerves. The trial team chose the top two candidates, R/S alpha lipoic acid and metformin, as the first drugs to test.

Recruitment has begun for the first participants at the University College London Hospitals NHS Foundation Trust (UCLH). There will eventually be up to 30 participating hospitals around the UK.

The Octopus trial is being led by Professor Jeremy Chataway and researchers from the Queen Square MS Centre and MRC Clinical Trials Unit at University College London (UCL). Professor Chataway is supported by the NIHR’s Biomedical Research Centre at UCLH and UCL.

Professor Chataway said: “The multi-arm, multi-stage approach to trialling emerging medications has been transformative in other conditions, so I’m thrilled we’re now able to apply it to progressive MS. Ultimately, Octopus will lead to more treatments for progression becoming available to people living with MS sooner.

“Getting to this stage has been an incredible joint effort of people up and down the country. The other large trial I am the Chief Investigator for, MS-STAT2, has shown we can run large-scale, nationwide trials for progressive MS. Now we're taking it to the next level, as we start a new journey to develop treatments for progressive MS. I know our amazing community of people is poised to help us make it to the top, so we can find the answers we so desperately need.”

Dr Emma Gray, Assistant Director of Research at the MS Society, said: “Launching the world’s first multi-arm multi-stage trial for MS has long been an ambition of ours, and opening the doors to Octopus is a momentous milestone. More than 130,000 people live with MS in the UK and there are tens of thousands with progressive forms who have nothing to stop their MS getting worse. By tapping into the potential of approved drugs, which may have the potential to protect nerves, we can develop new treatments for MS faster. This is a major moment for MS research – Octopus has the potential to change the clinical trials landscape around the world.”

Anyone who has primary or secondary progressive MS in the UK can register their interest via the UK MS Register.

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