Alpha lipoic acid shows promise in Stage 1 of Octopus trial in progressive MS
Results from Stage 1 of the Octopus trial find one of the trial treatments, alpha lipoic acid, shows promise in progressive MS and will continue into trial Stage 2.
- Results from Stage 1 of Octopus, the world’s first ‘multi-arm multi-stage’ trial for progressive MS, have been announced.
- One of the trial treatments, alpha lipoic acid, showed early promise in progressive MS and will continue in the next trial stage.
- The other trial treatment, metformin, will not continue in the trial.
World-first multi-arm multi-stage trial for progressive MS
Octopus is the world’s first ‘multi-arm multi-stage’ trial for progressive MS.
Treatment options for progressive MS are limited and remain an urgent unmet need. As MS Australia’s lived experience expert panel (LEEP) member Rachel Fallis notes, “Many people with progressive MS feel stuck or forgotten, but trials like Octopus offer hope”.
In progressive MS, symptoms usually get worse gradually, over many years. This can be tracked using tests like how quickly you can walk a certain distance or place pegs into small holes. But it can take a long time to see whether a potential treatment is slowing it down.
In clinical trials, this often means spending a long time testing a treatment that eventually turns out to be ineffective.
Octopus is doing things differently to get answers earlier. In the first stage of the trial, the team used magnetic resonance imaging (MRI) and other clinical assessment to get a sneak preview of each treatment’s potential. This design means we don’t have to wait years to find out if a treatment is worth continuing.
Treatments which look promising after this analysis will stay in the trial and move to Stage 2, where more people join the existing participants. This means that what would normally be two separate trials is delivered in one flexibly designed trial.
The multi-arm multi-stage trial design also speeds up the trial process by:
- Testing multiple treatments at once, across different treatment ‘arms’ of the clinical – and comparing them with a single placebo group.
- Adding the flexibility to drop treatments that don’t look promising, and slot in new treatments as they’re discovered.
In addition, Octopus is testing therapies that are already in use in Australia for other conditions, meaning they are already known to be safe. If the Octopus trial shows positive results, the path to approval will be faster.
The first two treatments tested in Stage 1 were alpha lipoic acid and metformin.
The results of Stage 1 of the trial have just been announced, showing that one of the trial treatments, alpha lipoic acid, is showing promise in progressive MS. This treatment will continue in Stage 2 of the trial whilst the other treatment, metformin, will be stopped.
Showing promise means the treatment produced enough encouraging signals in the early analysis to justify continued testing. It does not mean the treatment has been proven effective, is approved for general use or is guaranteed to work for everyone.
LEEP member Sarah Flaim, who lives with MS, believes “this milestone highlights why adaptive trials like Octopus are so important. Researchers can identify promising treatments sooner and focus resources where they are most likely to benefit people living with progressive MS.”
Octopus trial recruiting in the UK since 2023
Stage 1 of the Octopus trial recruited participants in the UK.
Octopus launched in the UK in January 2023 and has recruited around 849 people with primary and secondary progressive MS at 26 sites across the UK; and 4 participants at 1 site in Australia within PLATYPUS, the Australian extension of the Octopus trial.
Octopus is funded by the MS Society with supportive funding from University College London and sponsored by the UCL Innovative Clinical Trials Unit. The Chief Investigator of this international trial is Professor Jeremy Chataway. You can read more about the Octopus trial here.
While the analysis of Stage 1 was underway, the participants continued into Stage 2 of the trial, measuring clinical progression of disability. Recruitment into Stage 2 of the trial is ongoing both in the UK and Australia.
PLATYPUS: the extension of the Octopus trial in Australia in 2026
In Nov 2023, MS Australia and MSWA announced plans to bring an extension of the Octopus trial to Australia, called PLATYPUS. They provided funding support for PLATYPUS, led in Australia by Professor Simon Broadley under the leadership of the Octopus team in the UK.
Extensive work over the past two years has established the infrastructure needed to open the trial in Australia. This included ethics, government and institutional approvals, implementation of the Octopus drug management system, a national online registration portal for PLATYPUS and other MS trials called MS Trial Screen, biobanking systems, the ongoing setup of nine trial sites around Australia, and comprehensive oversight by national and international scientists, MS neurologists, clinical triallists and lived experience experts.
Australia joined the trial in Stage 2, with the lead trial site at Gold Coast University Hospital opening in October 2025. Four participants have been recruited in Australia, with additional sites to begin recruiting soon. You can read more about Australian trial sites here.
Results of Octopus trial Stage 1
The results of the early analysis have shown that alpha lipoic acid is showing early promise as a treatment for progressive MS.
Metformin did not show early signs of being effective in progressive MS and therefore will not continue in the trial.
These are promising early results for alpha lipoic acid. But this Stage 1 analysis is a checkpoint, not a finish line. We will only know for certain whether this trial treatment is safe and effective for people with progressive MS when we see the final results of the trial.
LEEP member Rachel Fallis says “Even early signs of promise mean a lot to people with progressive MS. We’ve waited a long time for new options, so seeing one treatment move forward gives real hope.”
How will the results be used?
Over the coming weeks, all trial participants in OCTOPUS-PLATYPUS will be contacted to instruct them on the next steps. All participants should continue taking their trial treatments and attending their visits until they’re contacted.
Alpha lipoic acid and those on placebo will continue into the next stage of the OCTOPUS-PLATYPUS trial. More people with progressive MS will now join the trial, to help us firmly answer the question of whether alpha lipoic acid is effective.
The innovative design of OCTOPUS-PLATYPUS means we find out whether trial treatments are effective for MS years sooner than we would have using a traditional trial design. This means fewer people taking ineffective treatments. Time and money can now be redirected to testing other promising treatments.
Taking treatments that haven’t been approved for MS outside of a clinical trial can put you at risk for example without the appropriate dosage, safety monitoring or management of contraindicated health conditions or incompatible medications. The effect of these treatments on MS remains unproven. If you’re not part of the OCTOPUS-PLATYPUS trial, and you’re considering taking alpha lipoic acid or metformin specifically for your MS, please speak to your doctor or MS nurse.
What happens next?
Metformin won’t continue in the trial. Participants who were taking metformin will be contacted by their study doctor or nurse and instructed to stop taking metformin and trial participation. Once participants have stopped taking the trial treatment, they could potentially reenter the trial after a minimum of 6 months.
The OCTOPUS-PLATYPUS trial will continue recruitment and site activation as planned, with the introduction of new promising treatments. The trial team has prepared for this outcome and has been researching new trial treatments. These will be introduced to the trial in the coming months.
We will continue to invite people with MS to join the trial for the current arms (alpha lipoic acid and placebo), and as new treatment arms are introduced.
You can still register your interest in joining the PLATYPUS trial, those who have previously registered interest remain on the register.
If you’re currently taking part in OCTOPUS-PLATYPUS, it’s important that you remain in the trial. Every piece of data is valuable. Your continued involvement is essential to delivering the final results, which could allow these trial treatments to be made available outside the trial in the future.
Thanks to all involved in this significant milestone
The first results of this world-first trial in progressive MS are a significant milestone.
We’re incredibly grateful to everyone who has contributed to the trial so far.
MS Australia extends our sincere thanks to:
- trial participants and their families for their contributions and commitment
- the University College London Innovative Clinical Trials Unit, the MS Society UK and the entire trials team for their tireless work in bringing Octopus to this first milestone and supporting the setup of Platypus in Australia.
- the Octopus hospital sites who have worked hard to recruit and support participants in Stage 1
- MSWA and other generous donors who are co-funding PLATYPUS in Australia.
For more information on the Octopus trial and the research conducted by the UCL team, you can visit their website here.
LEEP member Rachel Kerr was diagnosed with MS at age 17 and has lived with MS for 20 years. She says “Success for any treatment in progressive MS is a huge victory for those living with MS and their loved ones. This initial analysis is a significant step towards improved management of progressive MS and I am excited to see the progress”.
How to get involved with PLATYPUS
- Learn and register. Find out more about the PLATYPUS trial in Australia including how to register your interest.
- Already registered? If you have already registered your interest and selected preferred sites, you will be contacted as new sites are activated and participant places open up.
- Make a one-off donation. Directly support this vital clinical research today by visiting our donation pageand selecting ‘PLATYPUS trial’ as your chosen designation.
- Partner with us via a multi-year pledge. Contact us directly at info@msaustralia.org.au for a confidential discussion about structuring a multi-year pledge. This specialized partnership gives our researchers the certainty they need to turn initial trial recruitment into sustained clinical progress.
- Interested in clinical trials but don’t fit PLATYPUS criteria? You can find out about other trials within the Australian MS Clinical Trials Platform and register your interest, or learn about more MS trials and research seeking Australian participants here.
