MND-SMART: first results published
Sept 2024: The scientific data for the first two drugs tested in MND-SMART, memantine and trazodone, has been analysed, reviewed by experts, and published.
In September last year, we shared the outcome of testing the first two drugs in MND-SMART, our UK-wide clinical drugs trial. The data showed that there was no evidence that either of these drugs was slowing MND, and that they could be ruled out from further testing at the doses used in MND-SMART. These drugs were then removed from the trial.
Now, the findings have been scrutinised by independent peer reviewers, and published in a scientific journal called The Lancet Neurology.
MND-SMART started recruiting participants in 2020, and was globally one of the first multi-arm multi-stage (MAMS) trials for MND. The study described here includes data from 554 people with MND who generously consented to join the trial. They were randomly allocated to take memantine (183), trazodone (185) or placebo (186). This analysis point was reached when 100 participants in each arm had completed a minimum of 12 months follow-up.
The study found that neither memantine nor trazodone slowed the progression of MND, using a commonly used rating scale called ALS-FRS(R). In addition, neither drug showed a significant difference in survival compared with placebo. The trial was however shown statistically to be sufficiently large to have been able to detect any neuroprotective effects. Hearteningly, the participant withdrawal rate (10%) was lower than in historical MND trials (~20%).
The unique design and scale of MND-SMART has allowed investigators to obtain conclusive results within just over three years of the launch of the trial. If individual trials had taken place for each treatment, the researchers estimate the two results would have taken a minimum of eight years to report.
MND-SMART is led by Prof Suvankar Pal and Prof Siddharthan Chandran at the Euan MacDonald Centre, University of Edinburgh, with a team of collaborators UK-wide. This project was funded by the Euan MacDonald Centre, MND Scotland and My Name’5 Doddie Foundation.
MND-SMART continues to recruit participants across the UK and has now enrolled over 800 people with MND.
Related content
Read the scientific article: Pal et al, Safety and efficacy of memantine and trazodone versus placebo for motor neuron disease (MND SMART): stage two interim analysis from the first cycle of a phase 3, multiarm, multistage, randomised, adaptive platform trial, The Lancet Neurology, doi: 10.1016/S1474-4422(24)00326-0 (external website)
Register interest in joining the trial (UK only)
Announcement of trial results on Euan MacDonald Centre website (Sept 2023)