Sean Apap Mangion, MD, UCL Queen Square Institute of Neurology, London, UK, discusses the first multi-arm, multistage (MAMS) trial for multiple sclerosis (MS), which has recently been launched in the UK. The Octopus trial will simultaneously test numerous agents in patients with primary and secondary progressive MS, where there is an urgent unmet need for effective treatment options. The use of a common standard of care group, as well as the ability to drop agents from the trial that do not show promise and replace with new trial arms, makes the design highly efficient, saving time, reducing costs, and limiting the number of patients not in an active intervention arm. Initially, Octopus will test metformin and alpha-lipoic acid, two drugs that have shown neuroprotective effects in preclinical studies. Dr Apap Mangion highlights plans to expand this revolutionary trial approach to other neurological conditions where novel therapeutics are of great need. This interview took place at the European Academy of Neurology (EAN) 2023 Congress in Budapest, Hungary.
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