UCL Queen Square Institute of Neurology


Octopus: a new trial for progressive MS


Octopus Logo, MS Society.


Octopus is a revolutionary trial that will transform the way we test treatments for progressive MS. A smarter way of testing potential treatments, it could deliver life-changing new treatments up to three times faster. The trial team, based at University College London (UCL), have now launched this world first trial for patients with progressive MS.

Our progress:

  • Funding secured from the MS Society
  • Funding contract signed with UCL
  • Contracting with collaborators and contractors underway
  • Review of potential treatments to test
  • Final stages of drug selection
  • Trial launched in early April 2023

How will Octopus work?

Octopus is a multi-arm, multi-stage (MAMS) design – the first time this has even been done in MS.

MAMS trials make it possible to test new treatments up to three times faster by:

  • Testing multiple drugs at once – and comparing them with a single control group.
  • Using MRI to get an idea of whether a drug looks like it has potential, many months before we’d be able to see an effect of the drug on disability progression. Promising-looking drugs stay in the trial, with hundreds more people joining the existing participants. So what would normally be two consecutive trials are delivered in one.
  • Adding the flexibility to drop drugs that don’t look promising, and slot in new drugs which have the potential to be effective. 

Merging separate trials may sound obvious. But launching a MAMS trial for MS needs so many things to line up perfectly, from hospitals around the country equipped to be trial sites, to the incredibly complicated statistics that underpin the design.

Find out more about Octopus

About Multiple Sclerosis

Multiple Sclerosis (MS) is a progressive neurological disorder of the brain and spinal cord. It affects approximately 120,000 people in the UK and 2.5 million people globally. Most people with MS experience two stages of the disease: Early MS – Relapsing-Remitting MS (RRMS), which is partially reversible, and Late MS – Secondary Progressive MS (SPMS), which affects the majority of patients, usually after 10 to 15 years after diagnosis.

SPMS results from progressive neuronal degeneration that causes accumulating and irreversible disability affecting walking, balance, manual function, vision, cognition, pain control, bladder and bowel function. The pathological process driving the accrual of disability in SPMS is not known at present.

Immunomodulatory anti-inflammatory disease modifying therapies are increasingly effective in reducing relapse frequency in RRMS, however they have been unsuccessful in slowing disease progression in SPMS. This is the overwhelming conclusion from an analysis of 18 phase 3 trials (n=8500), of which 70% of the population had SPMS, all performed in the last 25 years. There is yet no current disease modifying treatment for SPMS.

Find out More about MS

People with MS and researchers at the National Hospital for Neurology and Neurosurgery and the UCL Queen Square Institute of Neurology in London have worked together to produce a film telling the human story of clinical research, “What it's like to have MS and the exploration of clinical research”. This film was commissioned and funded by the NIHR University College London Hospitals Biomedical Research Centre.

Page updated 06-04-2023.