A world-first trial is being launched in the UK into whether drugs already on the market can prevent multiple sclerosis (MS) from worsening and even reverse the disabilities it causes.
The Octopus trial will investigate the potential benefits of using a number of different medications at once, in the hope of finding effective new treatments up to three times faster than if the medicines were trialled separately.
Octopus – named because of its many arms – marks the culmination of years of planning for the ‘mega trial’ for progressive MS.
University College London has been announced as delivering the trial, with the MS Society confirming contracts have been signed, with Professors Jeremy Chataway and Max Parmar leading the research.
The initial drugs to be tested will be announced later in the year, with hundreds of patients being sought to participate. The trial will be randomly assigned to have either standard care for progressive MS or standard care plus one of three drugs that doctors hope will at least protect their neurons from the disease if not repair the damage done.
“In conventional trials, one group of people take the potential treatment. Another ‘control’ group take either an inactive placebo or a treatment already available for MS,” explains Dr Emma Gray, assistant director of research at MS Society.
“And each treatment goes through several ‘phases’. You start with a small group of people. If the treatment looks promising, you set up more trials with increasingly larger groups.
“Although this approach works, it takes a really long time. Octopus will speed things up by merging lots of these trials into one.”
About 130,000 people in the UK live with MS. The condition arises when the immune system mistakenly attacks the fatty myelin sheaths that wrap around nerves in the brain and spinal cord. Without the lipid-rich coating, electrical signals travel more slowly along nerves, are disrupted or fail to get through at all.
Through this multi-arm, multi stage (MAMS) design trial, Octopus will test multiple drugs at once, comparing them with a single control group, and are able to eliminate drugs from the trial at an early stage. More can then be added in, in a means of effectively merging two trials.
“Merging separate trials may sound obvious,” says Dr Gray.
“But launching a MAMS trial for MS needs so many things to line up perfectly, from hospitals around the country equipped to be trial sites, to the incredibly complicated statistics that underpin the design.”
