Tuesday, 14 July 2015

Guest Post: Please sign up to MS SMART


Hi there!
                 
I’m really excited to announce that we’ve started the MS-SMART trial in secondary progressive MS (SPMS) as part of the ongoing research in MS. Maybe some of you have seen the coverage this morning eg on the MS society website (http://www.mssociety.org.uk/). It’s been a long time coming, with a number of bumps in the road, but we’re here now!

This is part of the process of developing a really strong group of drugs that we hope will have an effect on slowing progression. We have to do these mid-phase trials (what we call phase 2), measuring MRI primarily, before we move to the final trials (phase 3) where we concentrate on disabilities such as walking. Though of course we will measure everything in this trial eg walking/arms/vision/memory (you name it!). This is because we want a really strong signal to move forward to the final and much more expensive late stage trials. But we know we can do phase 2 trials and we’ve seen success with simvastatin (MS-STAT trial) last year.

Here we’ve chosen 3 brand new drugs with some early evidence that they’ll work in SPMS and we’ll compare them to 1 dummy drug. All will look the same, and each person entering the trial will be randomly assigned to one of the 4 possibilities. These drugs have been used for motor neuron disease (MND), heart disease and depression: though of course that’s not what we using them for here. They are being re-purposed.

440 people can enter the trial, with the London Centres being National Hospital for Neurology and Neurosurgery (UCLH), Barts and The London and Imperial NHS Trust/Charing Cross. Please contact your neurologist or GP. I’m afraid the maximum disability is walking 20 metres with a frame or 2 sticks, the minimum walking about 500m or less. You can’t be on a DMT or an anti-depressant (apart from drugs such as amitriptyline) and must be able to have an MRI scan (there are 3 in the trial).

The trial lasts 2 years and we’ll recruit this year.

For more details, feel free to write an email to 
and go to the website www.ms-smart.org

All best wishes

Jeremy Chataway

Consultant neurologist and chief investigator

CoI: I am the PI on the trial and have no commercial/financial interests relevant to this trial. 

P.S. This trial is UK-wide

9 comments:

  1. It is shameful that PwPPMS have been excluded from this trial.

    Should these prospective drugs prove efficacious, they will have to be redone for PPMS, thus delaying treatment prospects farther.

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    1. Would trials really have to be redone for PPMS? I don't see why, given the school of thought that SPMS and PPMS are essentially the same. Surely an approved drug shown to slow / stop progression would not be denied to a person with PPMS?

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    2. Sterntaucher, it will not be licensed to treat PPMS. Litigation and all that.

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    3. Anon 4:51 - I'm cynical and hardbitten enough to believe that. But it would be scandalously and inhumanely nonsensical in my humble opinion.

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  2. You are kidding?
    I love the smug face of the chap who has excluded nearly 15% of the MS population and thinks it's ok?
    This is literally criminal nothing less

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    Replies
    1. AW, anon@6.51pm, perceptions are quite amazing. So coloured by our own needs, views, drives, wants etc. Essentially you can ascribe any characteristic to someone's face and that will depend on your thoughts and feelings, nothing to do with the person you are damning.

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  3. Just to add, I'm checking CSF neurofilaments as an add-on to the MS-SMART to see if any of these drugs reduce axonal loss. Based on the comments above if a drug dose reduce neurofilaments and is considered neuroprotective (not simply immunsupressive) then there is definite mileage for doing a drug trial in those with elevated neurofilaments regardless of walking distance and disease type. Hose to get the funding bodies think along these lines?? The general reply has been so far: ambitious project (interpretation, doesn't know what they are doing), may not have the resources (make what you may of this one).

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