Interim results from a world-first multiple sclerosis (MS) trial at UCLH and UCL have found that an existing medication, alpha-lipoic acid, is showing early promise as a potential treatment to slow progression in MS.
Researchers revealed that the drug could have potential to become the first neuroprotective treatment in MS. But they stress people should not attempt to acquire alpha-lipoic acid outside a clinical trial, as further research is needed to fully understand its efficacy - and particularly its safety - in MS.
While there are over a dozen treatments for those living with relapsing MS, tens of thousands with the progressive form desperately need treatments to stop their MS getting worse. Those drugs that do exist only work on one aspect of the condition – the immune system. They don’t stop the gradual nerve damage that leads to long-term disability. Finding ways to protect nerves from damage is key.
The Octopus trial uses an innovative multi-arm multi-stage (MAMS) design which means it can test potential new treatments up to three times faster than conventional trials. It has provided a blueprint for similar trials across neurological conditions, from motor neuron disease and Parkinson’s disease to psychosis. It has been testing two drugs at once - a high dose of alpha-lipoic acid and diabetes drug, metformin – and comparing each one against a placebo.
Alpha-lipoic acid will now continue to the second stage of the trial. Data from both stages will then be combined to provide a definitive phase 3 result. However, metformin did not demonstrate sufficient promise to be taken forward. This will now be removed from the trial, with all participants from that arm coming off the drug in the coming weeks.
More than 850 people have joined the trial at hospitals across the UK and Australia. Now the team are seeking hundreds more people living with primary or secondary progressive MS to sign up. Thanks to this positive result, in the coming years Octopus will become the world's largest ever trial in progressive MS. The trial design means other drugs could be added as soon as early 2027.
Octopus is being led by UCLH and UCL Professor Jeremy Chataway, who is supported by the BRC, and who said: “This is very exciting and proves not only that the Octopus trial design works, but that a new way of protecting nerves could be on the horizon. Of course, learning that metformin will be discontinued is disappointing. But finding treatments for progressive MS is extremely difficult, and we’re so pleased to be taking alpha-lipoic acid into the second stage of the trial. We’re now looking forward not only to seeing what the final results are, but also to adding in new ‘arms’ to Octopus next year. In the meantime, we do need to remind people with MS to not try to source unproven drugs outside the safety of a clinical trial.”
Anyone who has primary or secondary progressive MS and is aged between 25-70 in the UK can register their interest via the UK MS Register to take part in stage 2 of the Octopus trial. Please note there is a waiting list for the trial.
Watch a video of Prof Chataway summarising the trial results.
Image: Adobe Stock / New Africa
