On this special episode of The Raw Nerve podcast, recorded at the 2023 Progress in MS Research Conference in Perth, we take a deep dive into PLATYPUS, Australia’s groundbreaking adaptive clinical trial for progressive MS. Dr Julia Morahan, Deputy CEO at MS Australia, guides us through a captivating discussion with two of the brilliant minds steering the trial. Prof Simon Broadley from Griffith University, overseeing PLATYPUS and Prof Jeremy Chataway of University College London, Chief Investigator of the UK’s OCTOPUS trial.
PLATYPUS is the Australian extension of a revolutionary trial based in the United Kingdom (UK) called OCTOPUS, which aims to enrol participants in the UK and Australia over the next few years. It is the first-ever multi-arm, multi-stage (MAMS) trial for progressive MS. MAMS trials make it possible to test new treatments up to three times faster.
As part of the OCTOPUS trial, PLATYPUS will test multiple treatments with the aim to find one that can slow down, and ultimately stop, the progression of disability in people with primary or secondary progressive MS.
The trial aims to be a more efficient kind of clinical trial by using the multi-arm, multi-stage (MAMS) approach. It will run over a number of years. The trial has two stages and has now progressed to the second stage.
Initially, the trial compared two treatment groups, or ‘arms’, with one control group. New arms can also be added to the trial in the future to test other new and promising drugs. The treatments being tested first in the trial are a TGA-approved treatment (metformin) and a TGA-listed health supplement (alpha lipoic acid) that are already in use in Australia for other conditions. These treatments are largely focused on promoting the protection of nerves from damage, or ‘neuroprotection’.
Learn more about how researchers are working to stop MS.
In the first stage of the trial participants have magnetic resonance imaging (MRI) scans as well as other tests such as Expanded Disability Status Scale (EDSS), 25-foot walk and 9-Hole peg test. At the end of this stage, researchers review the MRI data from participants’ scans combined with the data from the other tests.
This analysis of Stage 1 data helps researchers decide whether the treatments under investigation are likely to be helpful in slowing disease progression. By combining the MRI and test data it makes the trial stronger and reduces the chance of missing something important.
If the combined data show that a treatment is not making a difference, then that arm will be stopped.
Any treatments that seem to have a beneficial effect on MS at this point of analysis will continue to be tested in the second stage.
Stage 1 results announced in September 2026
In September 2026, the results of Stage 1 from the OCTOPUS trial in the UK were announced. The results of this early analysis revealed that alpha lipoic acid was showing early promise as a treatment for progressive MS. However, metformin was not. Read more.
While awaiting Stage 1 results, the OCTOPUS trial entered Stage 2. PLATYPUS, the Australian extension of the OCTOPUS trial, launched in Australia and began recruiting in Stage 2 of the trial during October 2025.
In Stage 2, researchers look at clinical data to see whether the treatments can, in fact, slow down the progression of MS. More participants are invited to join the trial during this stage.
Next steps
Alpha lipoic acid will continue to be tested in Stage 2 of the trial.
Metformin will be discontinued. The trial team will be in contact with participants taking metformin to advise them about next steps. Participants who were taking metformin could potentially re-enter the trial after 6 months of stopping this trial treatment if they are still eligible.
The trial team hopes to add new trial treatments in the coming months.
