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Jeremy Chataway looks at an MRI image on a screen with his colleague

Full steam ahead with our ‘mega-trial’ for progressive MS

Dr Emma Gray

Over the last few years, a group of experts have been working on plans for a ‘mega-trial’ that will speed up development of treatments for progressive MS. Dr Emma Gray, our Assistant Director of Research, tells us how plans are progressing.

We haven’t exactly been living through normal times recently. But I wanted to let everyone know, despite the pandemic, we’re powering full steam ahead with plans for our ‘mega-trial’ for progressive MS, now named Octopus.

In fact, we’ve signed the official contracts with Professors Jeremy Chataway and Max Parmar from University College London who’ll be delivering the trial.

I know research progress can feel frustratingly slow, but this is a major milestone. After years of planning, our ambition to speed up clinical trials for progressive MS is going to become a reality. And by 2025 we hope to be in the late stages of testing treatments to slow or stop progression for everyone with MS.

Why do we need a ‘mega-trial’?

Clinical trials are the only way to find out whether a potential treatment is safe and effective.

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.

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.

How will Octopus work?

Octopus uses what’s called a multi-arm, multi-stage (MAMS) design – the first time this has even been done in MS.

MAMS trials make it possible to test new treatments up to three times faster by:

  • Testing multiple drugs at once – and comparing them with a single control group.
  • Using MRI to get an idea of whether a drug looks like it has potential, many months before we’d be able to see an effect of the drug on disability progression. Promising-looking drugs stay in the trial, with hundreds more people joining the existing participants. So what would normally be two consecutive trials are delivered in one.
  • Adding the flexibility to drop drugs that don’t look promising, and slot in new drugs as they’re discovered.  

Merging separate trials may sound obvious. 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.

Can you take part?

Octopus isn’t ready for people to take part yet.

In the summer, we hope to finalise which treatments Octopus will test first. And in the autumn, people with progressive MS should be able to register their interest in participating.

I’ll keep you updated on our progress throughout the year, and we’ll be sharing a lot more information about who can take part when all the details are confirmed – so watch this space.

I’m really excited for Octopus to get going. And I know the researchers really believe Octopus will help us stop MS much sooner.

In the meantime, there are other ways to get involved with MS research. Like the MS STAT2 trial which is currently recruiting people with secondary progressive MS. And ChariotMS which will soon be recruiting participants with advanced progressive MS.