Saturday, 13 February 2016

MS SMART Still Recruiting


MS-SMART (Multiple Sclerosis-Secondary Progressive Multi-Arm Randomisation Trial)
February 2016

Hi there!

Following Dr Chataway’s previous post on this blog, we wanted to inform you that recruitment is still ongoing for the MS-SMART trial and will end April 2016.

MS-SMART is a phase 2 clinical trial looking at disease progression in people with secondary progressive MS (SPMS). The study involves testing one of three different drugs (amiloride, riluzole and fluoxetine) against a placebo (dummy drug) to see if they can slow down the worsening of disability. As you are aware, this trial is important as there is currently no treatment for progression in MS.

You can read more about MS-SMART on our website:

or the MS Society website (CLICK HERE):

The trial inclusion criteria include:
-Diagnosis of SPMS
-Steady progression of clinical disability in the preceding 2 years
-Still able to walk at least 20 metres with bilateral support (EDSS: 4.0-6.5)
-Aged 25 to 65 (inclusive)
-Able to undertake MRI
-Not on certain medications including: MS disease modifying therapy, fluoxetine, citalopram, escitalopram, and sertraline

So far, at all of the UK MS SMART recruiting sites, we have almost reached our participant target, and are getting in touch to see if anyone would be happy to attend our centre where we can offer you an appointment soon to check whether you might be eligible. We are based at the main MS-SMART site at UCL, Institute of Neurology, Queen Square, London.

Working together we can meet our target. If you are interested in taking part, please contact us via:

Email: domenico.plantone@nhs.net
Or call: 07572898453

Thank you in advance,
Dr Domenico Plantone

On behalf of Dr Jeremy Chataway and the MS SMART team 


8 comments:

  1. I'd like to add that as part of an add on study, I'm measuring neurofilament levels in the spinal fluid to see if they reduce the rate of axonal breakdown. In my books this is a true reflection of weather a drug has neuroprotective potential.

    The lamotrigine trial in SPMS demonstrated a drop in neurofilaments but the primary outcome which was brain volume loss was negative! A subsequent analysis of the data revealed that those on lamotrigine in fact were better in their walking than those on placebo! - that's clinical trials for you.

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  2. I've registeed my interest at the Oxford Centre - are they still recruiting? Will I miss my chance to participate unless I register for the Queen Square Centre? Thank you

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    1. Please email Domenico, he'll be able to verify your status with the Oxford centre.

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  3. All,

    Why does escitalopram usage exclude someone from this trial?

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    1. Escitalopram is an SSRI which is very similar to fluoxetine. I believe the trial is allowing a wash out of the SSRI if possible to allow participation in the trial.

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    2. Dear NDG,

      That's odd, my first MS attack happened about 36 hours after my last dose of Escitalopram.

      I started on citalopram in 2008 for depression and eventually started to work on the underlying issues in 2011/12. Started psychoanalysis four times a week in 2012 with a psychiatrist, switched to Venlafaxine in 2012 but that just wasn't that great for me so I switched to Escitalopram at the end of 2013. In the summer of 2014 therapy was going well and I wanted to stop taking the anti depressant. Under my doctor's supervision we started to taper the dosage. During the taper process I started to notice things off level first thing in the morning - the pavement would look like I was heading up hill. About 24 hours after my last dose I was on the shrink's couch and I had to get out my phone and use the spirit level app to check the walls - nothing looked level. Next morning at 03:30 I woke up with very severe discontinuation symptoms - over the following days I tried to push through but had to start back on the escitalopram 3 days later. All symptoms cleared instantly apart from the vertigo, because of family history had an MRI etc etc ...

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  4. I do have a concern about fluoxetine (Prozac). A side effect can be increased anxiety. I know from having RRMS anxiety is not good for my MS, it is a relapse trigger for me. I will be interested to read the results of this trial.

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