Technology and MND: Highlights from Glasgow

This blog is part of the ‘Highlights from Glasgow’ collection of articles, where you can read about the content of some of the talks and posters presented at the 29th International Symposium on ALS/MND.

Where to start on a subject as wide and varied as technology and MND?

Indeed, this problem is not just limited to a simple blog post, it is a challenge for us as an MND charity faced with a proliferation of potentially beneficial technological developments in smartphones, wheelchairs, and exoskeletons to name but a few.

Fortunately, there is a fundamental question that can help us make sense of it all and it is a question that stems from our Association values – What does this mean for people with MND? I’ll be trying to answer this question as part of my summary of technology talks from our 29th International Symposium.

Much of the content that was presented related to the use of technology in clinical trials, so let’s start by considering clinical trials and what we want from them:

  • We want them to be efficient and report results quickly – this means they will be cheaper, so we can do more of them and secure a cure or effective treatment for MND more quickly.
  • We also want the trials to be reliable and give accurate results whilst allowing as much patient participation as possible.
  • Above all, we want trials to translate into tangible change such as clinical developments that improve quality of life or the introduction of an effective treatment for MND.

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Clinical trials: Highlights from Glasgow

This blog is part of the ‘Highlights from Glasgow’ collection of articles, where you can read about the content of some of the talks and posters presented at the 29th International Symposium on ALS/MND.

In the Clinical trials and trial design (4B) session we heard from two speakers looking at ways to improve current design of clinical trials. In his plenary talk, Mahesh Parmar (C20) provided his perspective on the necessity of changes from his experience working on cancer trials, highlighting that any efforts to improve clinical trials should be focused on Phase 3 where the most money and time is spent. One solution that stuck with a lot of clinicians attending Prof Parmar’s talk was the design used in the STAMPEDE trial, a large clinical trial assessing effectiveness of new treatments for people affected by prostate cancer, which has been running since 2005. The innovation of this approach is the ongoing protocol that allows to test multiple treatments within the same established clinical trial, allowing new drug candidates to be tested (relatively) straight away, avoiding the creation of a brand new clinical trial. This design improves efficacy of testing new treatments, systematic approach to testing, and access to a large pool of participants who could take part in multiple treatment trials over time.

Brian Dickie, the Director of Research Development at the MND Association said: “Prof Parmar’s presentation generated a lot of interest amongst clinicians who are regularly involved in MND trials and there was a strong feeling that this is the direction that we need to be taking with MND as it could increase the efficiency and reduce the cost. That said, it will take a while to put the building blocks in place and we certainly wouldn’t want to hold up trials that are already in advances stages of planning, so I would expect to see a gradual introduction of changes to trials design over the coming years.”

You can learn more about the multi-arm multi-stage trial design from Prof Parmar here.

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