Alpha lipoic acid shows ‘early promise’ to treat progressive multiple sclerosis
17 Sep 2026
Interim results from the OCTOPUS trial have found that an existing medication, alpha lipoic acid, is showing early promise as a potential treatment to slow progression in multiple sclerosis (MS). Metformin showed no evidence of promise.
Researchers from the Queen Square MS Centre and UCL Innovative Clinical Trials Unit revealed that the drug could have potential to become the first neuroprotective treatment in MS. But they stress people should not attempt to acquire alpha-lipoic acid outside a clinical trial, as further research is needed to fully understand its efficacy and safety in MS. We will only know for certain whether alpha lipoic acid is safe and effective for people with progressive MS when we see the final results.
MS can be debilitating, exhausting and unpredictable, and symptoms range from chronic fatigue and bladder and bowel problems to mobility difficulties. While there are over a dozen treatments for those living with relapsing MS, tens of thousands with the progressive form desperately need treatments to stop their MS getting worse. Those drugs that do exist only work on one aspect of the condition – the immune system. They don’t stop the gradual nerve damage that leads to long-term disability. Finding ways to protect nerves from damage is key.
The OCTOPUS trial, led by Professor Jeremy Chataway, uses a multi-arm multi-stage (MAMS) design which means it can test potential new treatments for progressive MS up to three times faster than conventional trials. OCTOPUS has provided a blueprint for similar trials across neurological conditions, from motor neuron disease and Parkinson’s disease to psychosis. It has been testing two drugs at once: a high dose of alpha lipoic acid and the diabetes drug, metformin, and comparing each one against a placebo.
Its multi-arm, multi-stage design means that partway through the trial, the team can get a sneak preview of whether each drug looks promising. This is called the interim analysis.
The interim analysis looked at MRI and clinical data from the trial. It found that:
- Alpha lipoic acid shows early promise as a treatment to protect nerves in MS. It’ll now continue to the next stage of the trial. These are promising early results for alpha-lipoic acid.
- But the interim analysis is a checkpoint, not a finish line. Now the team are seeking more people living with primary or secondary progressive MS to sign up to join those on the existing waiting list for the trial. This will help us firmly answer the question of whether it's safe and effective at slowing disability progression.
- Metformin showed no evidence of promise at the interim analysis. It won’t continue to the next stage of OCTOPUS. People who were taking metformin as part of OCTOPUS will leave the trial.
These results show the trial is operating exactly how it is designed to. By dropping a drug that does not show promise, people spend less time taking treatments that don’t work and precious time and money aren’t wasted. We will find out whether alpha lipoic acid is safe and effective for MS years sooner than we would have using a traditional trial.
More than 850 people have joined the trial at hospitals across the UK and Australia. Thanks to this positive result, in the coming years OCTOPUS will become the world's largest ever trial in progressive MS. The trial design means other drugs will be added as soon as early 2027.
Anyone who has primary or secondary progressive MS and is aged between 25-70 in the UK can register their interest via the UK MS Register to take part in stage 2 of the OCTOPUS trial.
OCTOPUS is funded by UK MS Society with supportive funding from InCTU at UCL (Grant reference 135). In Australia it is supported by funding from MS Australia and MSWA as part of a National Collaborative Platform of MS Australia. It is being carried out in 27 hospitals in the UK and Australia.
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