A multi-arm trial funded by the MS Society has moved high-dose alpha-lipoic acid into stage two after early positive signs; metformin has been dropped from the trial.
Alpha-lipoic acid (ALA), an antioxidant and anti-inflammatory medicine, has progressed to the second stage of the Octopus multi-arm, multi-stage trial for progressive MS.
Octopus has recruited more than 850 participants across the UK and Australia and is designed to add or drop treatment arms efficiently.
Researchers and the MS Society stress that ALA should only be used inside clinical trials until safety and dosing are confirmed.
# What happened The Octopus trial, a world-first multi-arm, multi-stage (MAMS) study for people with progressive multiple sclerosis (MS), has progressed one existing drug—alpha-lipoic acid (ALA)—into its second stage. Trial leaders describe the results as "exciting" and say ALA showed early promise in slowing disease progression. The diabetes drug metformin was removed after it failed to demonstrate positive findings in this trial.
# Why this matters
# Who is running the trial and who's involved
# What the researchers and MS Society say UCL neurologist Professor Jeremy Chataway, the trial lead, called the findings "very exciting" and said Octopus proves the trial design works and that a new way of protecting nerves could be on the horizon. He warned people not to try to source unproven drugs outside a clinical trial because safety and dosage need full assessment.
Dr Emma Gray, director of research at the MS Society, said the organisation is proud to fund the first-ever MAMS trial for people with progressive MS. She framed the results as a substantial step forward and noted continued fundraising will be needed to maintain the trial and add new drug arms.
# Patient perspective Ailsa Guidi, a trial participant diagnosed with relapsing MS in 1999 who progressed to secondary progressive MS in 2023, described the trial experience positively. She said taking part shifts conversations toward finding treatments that could help thousands living with progressive MS.
# Practical details for patients Eligibility: People with primary or secondary progressive MS aged 25 to 70 in the UK can register interest. How to register: Visit the UK MS Register page for Octopus at www.ukmsregister.org/octopus. Trial design: The MAMS framework allows new treatment arms to be added and unsuccessful arms to be stopped without restarting the whole trial.
# What remains unknown The Octopus announcement reports early promise for ALA but does not provide final efficacy or safety data. Researchers emphasize further research is required to establish correct dosing, long-term safety, and definitive benefit. Metformin's discontinuation indicates not all repurposed drugs will succeed in this setting.
# Bottom line Octopus has advanced alpha-lipoic acid into a later stage based on early findings and dropped metformin. The trial's adaptive design and public funding are central to rapidly testing multiple candidate drugs for progressive MS. Participation is ongoing and confined to formal trial settings until robust results are published.
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