Clinical Trials (Part 2) – Posters: Highlights from Perth

This blog is part of the ‘Highlights from Perth’ collection of articles, where you can read about the content of some of the talks and posters presented at the 30th International Symposium on ALS/MND in Perth.

With this years International Symposium on ALS/MND now behind us, it is time to reflect on some of the news that was presented by researchers.

Researchers are invited to present their work as either a platform (oral) presentation or as a poster. Results and updates from several clinical trials of potential new treatments for MND were presented as posters, and some of these have also found their way into various online news articles. This blog will look at some of these results and their potential as new treatments for MND.Read More »

Clinical Trials (Part 1) – Platform Presentations: Highlights from Perth

This blog is part of the ‘Highlights from Perth’ collection of articles, where you can read about the content of some of the talks and posters presented at the 30th International Symposium on ALS/MND. All presentations have a code beginning with ‘C’ followed by a number (e.g. C50). This will help you locate the specific abstract mentioned throughout the post in the official abstract book.

Researchers are invited to present their work as either a platform (oral) presentation or as a poster. Session 2B of the Symposium’s platform presentations looked at clinical trials. Here we summarise the session with four talks reporting concepts, updates and results of the trials being investigated. This includes the Healey ALS Platform Trial, Ibudilast, NurOwn, and Tofersen.

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TUDCA-ALS has started recruiting in the UK

TUDCA-ALS is a European Consortium (funded by the European Commission under the Horizon 2020 grant) involving top researchers from seven countries across Europe (see Figure 1). The Consortium aims to find a new treatment to slow down the progression of MND/ALS by conducting a clinical trial to investigate the safety and efficacy (effectiveness) of Tauroursodeoxycholic acid (also known as TUDCA).Read More »

ALSUntangled – untangling the mysteries of alternative and off-label treatments

There are literally thousands of websites on the internet that make claims about amazing alternative or off-label treatments (AOTs) and even cures for MND but with little or no scientific evidence to back these claims up. This presents a real problem for people living with the disease who may want to try them. Are they safe? Will they help? Or are they going to cause more problems than they solve?

Bedlack, Dr Rick

 

In 2009 Dr Richard Bedlack, Professor of Neurology at Duke University in the USA, founded ALSUntangled to develop a system of review for some of these treatments using the available evidence, to make it easier for people with MND and their families to make more informed decisions about them.Read More »

New gene therapy targeting C9orf72-ALS begins Phase 1 clinical trial in the UK

This article was written by Dr Keith Mayl and Dr Ahmad Al Khleifat of King’s College London.

Researchers at King’s College Hospital, led by Professor Christopher Shaw, have embarked on the first gene therapy clinical trial for patients affected by a specific genetic form of ALS, the most common type of MND.

ALS is a progressive disease in which the nerves controlling muscle movement, known as motor neurons, degenerate resulting in muscle wasting and weakness. In about 10% of people the cause is a mutation in the C9orf72 gene. This mutation results in the formation of toxic products which are harmful to motor neurons. People with the mutation typically develop symptoms in their 50s, starting with speech and swallowing problems, followed by weakness of the arms, legs and breathing. It is also linked to problems with language and behaviour and is the most common genetic cause of frontotemporal dementia.Read More »

How animals are helping to improve our understanding of MND

‘From antibiotics and insulin to blood transfusions and treatments for cancer or HIV, virtually every medical achievement in the past century has depended directly or indirectly on research using animals’ – from the Royal Society’s position statement on the use of animals in research.

We know that talking about using animals in research is an emotive topic. We appreciate that some people will never accept that using animals in research is necessary, and we understand that it is not our place to try and influence anyone’s opinion on the use of animals in research. The purpose of this blog is to explore how using animal models of MND can further our understanding of this devastating disease, and how animals make it possible for potential new treatments for the disease to move forward into clinical trials in people.Read More »

Tofersen: antisense oligonucleotide drug shows promising results in Phase 1/2 trial

A recent press release by the pharmaceutical company Biogen reported preliminary results from an ongoing clinical trial investigating a form of precision therapy in people with SOD1-related MND. This drug, known as tofersen, is now in the final stages of Phase 1/2 testing in centres across the world, including Sheffield in the UK.

Tofersen is an antisense oligonucleotide (ASO), designed to prevent the faulty disease-causing protein from being made. Proteins, the building blocks of the body, are created from our genetic information (DNA) via its photocopy (RNA). If a piece of DNA is damaged, the RNA will also be damaged, leading to formation of a faulty protein and creating issues in the body. Tofersen is a synthetically-created RNA directed to stick to the faulty photocopy (RNA) preventing it from making faulty proteins.Read More »

Paving the way towards better clinical trials

“The annals of ALS clinical trials is strewn with failed studies. Only two out of more than 70 clinical trials have been positive, and even these showed only very modest benefit.  Is this dismal record strictly due to the extraordinary complexity of neurodegenerative disease in general, and ALS in particular?  Or is it due to methodological flaws that could be repaired?” 

Robert G Miller, Professor of Neurology, Stanford University

Although there is not much we can do about disease complexity, improving the way treatments are trialed is something that can be achieved. Imagine a world without clinical trials, where independent companies or individuals would be allowed to sell their self-made ‘drugs’ without any evidence that they were ever used on anyone with the disease, let alone that they would improve one’s condition. No one would know what the drug is (which could simply be a water solution), how it works and whether as soon as the drug is taken, we would be poisoned.

Thankfully, this is not the case and clinical trials, although not perfect, are considered the gold standard for approving any treatment.  However, there are still some improvements that can be done to make trials easier to access and provide more accurate estimates of drugs’ effectiveness much faster.

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Drug repurposing – harnessing the positive side effects of ‘old school’ drugs

Is it possible that a drug that treats congestive heart failure could improve respiration in people with MND? Or that a drug used to treat cancer could reduce motor neuron inflammation and possibly slow progression of the disease? In this blog we take a look at drug repurposing – using a drug developed to treat a particular disease to treat another that is unrelated – what it is, and what it might mean for people living with MND.Read More »

Cannabis-based products for medicinal use

In November 2018 the Home Office released a draft Guideline scope for Cannabis-based products for medicinal use in which they announced that specialist doctors (like consultant neurologists) on the Special Register of the General Medical Council will be able to prescribe cannabis-based medicinal products to some patients. Before this, the only cannabis-based medicines licensed for use in the UK were nabiximols (Sativex), used as a treatment for spasticity (where muscles are continuously contracted, causing stiffness or tightness of the muscles, interfering with normal movement and speech), in multiple sclerosis (MS).Read More »