Getting the low-down on Octopus

Mon 04 November 2019

Dr Emma Gray

Dr Emma Gray, our Assistant Director of Research, gives us the low-down on our new clinical trial, Octopus.

Our number one goal is for everyone with MS to have effective treatments to slow, stop and one day reverse disability progression. Although we've made great progress in finding treatments for relapsing MS, there's still too many people with progressive MS who have nothing to slow or stop progression.

So we’re stepping up the pace of research.

Octopus is our new multi-arm, multi-stage (MAMS) platform trial, led by Professors Jeremy Chataway and Max Parmar from University College London. Octopus is designed to develop treatments more efficiently than traditional trials. 

Speeding up the development of new treatments for MS

In traditional trials, a potential treatment is compared to a placebo (dummy drug) or existing treatment. If it looks safe and effective in a small group of people, you set up a new trial to test it in a larger group.

This is effective, but not always efficient. We can only test one drug at a time, it takes a long time and is very expensive.

Octopus will streamline the process. It’ll provide a structure to test new and repurposed drugs (those that are already used in other conditions) more quickly and cheaply. People with primary and secondary progressive MS will be able to take part at hospital sites around the UK.

The benefits of a MAMS trial

MAMS trials have been shown to significantly reduce research timelines in other conditions, like prostate cancer.

  • We can test multiple drugs at once – and compare them with a single control group. This is what makes it multi-arm.
  • We can use MRI to get an idea of whether a drug looks promising in the brain, months before we could see an effect on disability. If it does, hundreds more people join the existing participants. So what’s normally two consecutive trials are delivered in one. This is what makes it multi-stage.
  • We can have a rolling programme, adding new treatments as they're discovered and removing drugs that aren’t showing potential.

We've already demonstrated we can run more efficient trials with our MS-SMART trial. MS-SMART was a multi-arm trial which tested three drugs against a placebo. We’re excited to now combine the multi-arm approach, with the multi-stage approach, the first time this has ever been done for MS.

Progress so far

The trial team have been working hard to get Octopus ready. There’s a lot involved in setting up a first-of-its-kind trial like this, including:

  • Preparing the trial protocol, which is like a huge recipe book containing every detail of how the trial will run. And getting approval from the regulators and ethics bodies.
  • Identifying the first treatments to be tested in Octopus. And finding a drug manufacturer to do what’s called ‘over-encapsulation’. That’s where you make the tablets for the drugs and placebo look identical, so people don’t know which they’re taking.
  • Developing the trial database to store all the data from people taking part. And building the infrastructure so trial sites can do the MRI scans and send their data to the MRI experts at Queen Square MS Centre.

People can now register their interest in Octopus through the UK MS Register portal. And the trial team are working hard to get sites ready to open to participants.

A transformed clinical trials landscape for progressive MS

Just a few years ago there weren’t many trials for progressive MS. But now Octopus is joining other exciting trials, like:

  • Professor Chataway’s MS-STAT2 trial. This is a phase 3 trial, so it’s the last stage of testing before a treatment can be licensed. Recruitment closed in 2021, with 964 participants joining.
  • The ChariotMS trial, which is the first trial focused specifically on more advanced MS. It’s also the first trial with no upper age limit.

The results of these trials are expected by the end of 2025, thanks to the many wonderful people taking part over many years!

This blog was updated in March 2023 to reflect Octopus' latest progress.

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