A new trial for people living with relapsing-remitting multiple sclerosis launches in the UK
01 Jun 2026
A new clinical trial for people living with relapsing-remitting multiple sclerosis (MS) has launched in the UK. The REFINE-MS trial will evaluate if people living with relapsing-remitting MS can take treatment less often while keeping their disease activity under control.
The trial uses a novel design called multi-arm, multi-stage response over continuous interventions or MAMS-ROCI. It aims to test different time intervals between doses of treatment, to find out whether people can receive treatment less often without their MS getting worse. The focus is on ocrelizumab, a commonly used treatment for people living with relapsing‑remitting MS. Ocrelizumab works by targeting specific immune cells that can damage the brain and spinal cord, helping to reduce MS‑related damage and lower the risk of relapses.
Ocrelizumab is a highly effective treatment, but long‑term use can be associated with side effects, including a higher risk of infections. The treatment is usually given every six months, either through a drip into a vein or an injection under the skin, which means people need to attend clinic visits regularly. Ocrelizumab is also a costly treatment for healthcare systems and for the individuals who need to travel to the hospital and take time off work and education.
During the COVID‑19 pandemic, many people had the treatment less often, and evidence from routine clinical practice and clinical trials using the ‘parent’ of ocrelizumab (rituximab) suggests that the benefits of ocrelizumab may last longer than six months. This raises the possibility that less frequent treatment could still keep the disease under control, while reducing side effects, clinic visits, and costs for healthcare systems. The REFINE-MS trial is designed to test whether this approach is safe and effective.
The trial plans to recruit 540 participants in total. To join REFINE-MS, participants must have been stable on ocrelizumab treatment for at least one year before taking part.
It will run in two stages. In the first stage, the first 100 participants will be randomly assigned to receive treatment every six months (the usual care) or every twelve months. In the second stage, participants will be randomly assigned to one of five groups, receiving treatment every 6, 9, 12, 15, or 18 months. They will be followed for at least two years.
REFINE-MS is now open, and the first participant has been recruited at UCLH (London). More trial sites are expected to open over the coming months.
People living with MS have been involved in co-designing the trial, providing input on which treatment to study, what to do if the disease activity returns and how often participants should be contacted.
The REFINE-MS trial is funded by the National Institute for Health and Care Research (NIHR)- Efficacy and Mechanism Evaluation Programme (EME), grant reference 23/174. The trial is sponsored by University College London (UCL), with trial management delegated to the UCL Innovative Clinical Trials Unit.
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