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Brief Title: Multiple Sclerosis-Simvastatin Trial 2
Official Title: A Phase 3 Randomised, Double Blind, Clinical Trial Investigating the Effectiveness of Repurposed Simvastatin Compared to Placebo, in Secondary Progressive Multiple Sclerosis, in Slowing the Progression of Disability
Study ID: NCT03387670
Brief Summary: Multiple Sclerosis (MS) is a progressive neurological disorder of the brain and spinal cord. It affects approximately 120,000 people in the United Kingdom 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 (DMTs) 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 no current disease modifying treatment (DMT) for SPMS. In an earlier study (Multiple Sclerosis-Simvastatin 1; MS-STAT1), 140 people with SPMS were randomly assigned to receive either placebo or simvastatin for a period of two years. The investigators found that the rate of brain atrophy (loss of neurons - 'brain shrinkage'), as measured by magnetic resonance imaging (MRI), was reduced in patients receiving simvastatin compared to those taking placebo. Several other long term studies have also reported that there might be a relationship between the rate of brain atrophy and the degree of impairment. The study is designed to test the effectiveness of repurposed simvastatin (80mg) in a phase 3 double blind, randomised, placebo controlled trial (1:1) in patients with secondary progressive MS (SPMS), to determine if the rate of disability progression can be slowed over a 3 year period. The results generated from this trial may help to improve the treatment options of people with MS. In addition, taking part in this trial will mean regular review by an experienced neurologist regardless of the drug that patients are randomly allocated to receive.
Detailed Description:
Minimum Age: 25 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Belfast City Hospital, Belfast, , United Kingdom
Royal Sussex County Hospital, Brighton, , United Kingdom
Addenbrooke's Hospital, Cambridge, , United Kingdom
University Hospital of Wales, Cardiff, , United Kingdom
The Anne Rowling Regenerative Neurology Clinic, Edinburgh, , United Kingdom
Royal Devon and Exeter Hospital, Exeter, , United Kingdom
The Queen Elizabeth University Hospital, Glasgow, , United Kingdom
Leeds General Infirmary, Leeds, , United Kingdom
The Leeds Teaching Hospital, Leeds, , United Kingdom
The Walton Centre NHS Foundation Trust, Liverpool, , United Kingdom
Queen's Hospital, Barking, Havering and Redbridge University Hospitals, London, , United Kingdom
King's College Hopsital, London, , United Kingdom
Charing Cross Hospital, London, , United Kingdom
University College London Hospital, London, , United Kingdom
Salford Royal Hospital, Manchester, , United Kingdom
Royal Victoria Infirmary, Newcastle Upon Tyne, , United Kingdom
Nottingham Teaching Hospitals, Nottingham, , United Kingdom
Queen's Medical Centre, Nottingham, , United Kingdom
John Radcliffe Hospital, Oxford, , United Kingdom
Derriford Hospital, Plymouth, , United Kingdom
Poole Hospital, Poole, , United Kingdom
Royal Hallamshire Hospital, Sheffield, , United Kingdom
University Hospital of North Staffordshire, Stoke-on-Trent, , United Kingdom
Morriston & Neath Port Talbot Hospitals (Abertawe Bro Morgannwg University Local Health Board), Swansea, , United Kingdom
Name: Jeremy Chataway
Affiliation: University College, London
Role: PRINCIPAL_INVESTIGATOR