In the first worldwide “mega-trial”, UK experts will be testing a range of drugs already approved for other conditions for the treatment of multiple sclerosis (MS).
The multi-armed experiment – aptly named Octopus – will be led by professor of neurology Jeremy Chataway and professor of medical statistics and epidemiology Mahesh (Max) Parmar from University College London after years of planning with the MS Society UK, which is funding the trial through its Stop MS application.
The lawsuit will assess whether treatments already available on the market can reverse the devastating decline caused by MS and even reverse the disabilities caused by the disease.
The Octopus test sees researchers study multiple drugs simultaneously and hundreds of patients are recruited and randomly assigned to routine care for advanced MS or routine care accompanied by treatment with one in three drugs, yet to be finalized, which the team believes could potentially protect their neurons or possibly repair damage that has already been done.
Octopus uses multi-arm, multi-arm design (MAMS) – the first time this has ever been done in MS – which makes it possible to test tests up to three times faster.
“It’s a more efficient way to go. I want this to mean we can get effective treatments for advanced MS more quickly, ”said Chataway The Keeper.
The MAMS test sees the team test multiple drugs at once and compare them to one control group. MRI scans are used to quickly see if a drug appears to have the potential “many months before we could see the effect of the drug on the progression of disability”, MS Society deputy director of research Dr Emma Gray said in a post blog.
“Promising drugs will stay the test, with hundreds more joining the participants. So usually two consecutive tests are delivered in one. ”
The flexible nature of the test will allow the team to dispense unsuccessful looking drugs, and introduce new drugs as indicated.
The Octopus trial could bring life-changing to around 130,000 people in the UK living with MS – a condition that causes the immune system to attack the myelin sheaths that circulate around nerves in the brain and spine. This causes electrical signals to slow down on the nerves or fail through at all, resulting in anxiety, tingling, loss of balance and vision issues in the early stages. Many patients experience a relapsing-remitting form of the condition first and experience a cycle of incoming and outgoing symptoms as nerves are damaged and repaired just for be damaged again.
About half of MS patients have a progressive form in which zero damage progresses steadily and leads to a gradual decline into disability. These patients often suffer from tremor, speech problems and muscle stiffness and spasms, and may be unable to walk and require a wheelchair.
The drugs currently on the market for the treatment of MS are largely anti-inflammatories that prevent the immune system from invading the central nervous system. but there are limited options for treating many patients with more aggressive progressive MS.
“Whether we can protect nerve cells and regenerate myelin, that’s where the battlefield is now,” Chataway said.
MS Society says it hopes to end the treatments that Octopus will first test in the summer of 2021 and before the autumn patients with advanced MS should be able to express their interest in taking record part.
In the meantime there are a few more tests currently underway, or soon to be recruited for MS research – the MS-STAT2 test for advanced MS is testing whether anti-cholesterol drugs simvastatin protects against zero damage in patients with secondary advanced MS, and who are currently recruiting participants. The Chariot MS test, another MS Society-funded study, examines whether cladribine can reduce arm and hand function decline in patients with advanced MS.
Diabetes drug metformin has also emerged as a potential treatment option, having been shown to be able to repair myelin damage in animals. The cancer drug bexarotene has been found to repair nerves in humans as a proof of concept, but its side effects are too severe for use as a treatment for MS.
Experts at MS Society believe that the best approach to the treatment of MS is a combination of immunomodulatory drugs and anti-inflammatory drugs combined with medications that can protect against zero damage and those that can repair damaged myelin.
“I’m really excited to get Octopus going,” said Gray. “And I know the researchers really believe that Octopus will help us stop MS much faster.”
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