Current drugs being tested

MND-SMART is currently testing two drugs to see if either of them slow down the progression of MND compared with a placebo (dummy drug).

Memantine

The first drug, memantine, is already used to improve the memory of people with Alzheimer’s disease (a form of dementia) by reducing the action of a brain chemical called glutamate. Previous trials have tested memantine on people with MND but not in large enough numbers to provide any conclusive evidence as to the effects of the drug. These previous trials showed some evidence of functional improvement and the drug caused no notable side effects. Investigators also reported slowing of spinal motor neuron loss so it is thought that this drug may slow the damage to neurons in people with MND.

Trazodone

The second drug, trazodone, is used widely in the treatment of anxiety and depression. It has been shown to protect neurons in animal studies by slowing production of faulty proteins that can cause neurons to die. Trazodone has been tested in other neurological conditions including Parkinson’s disease, Alzheimer’s disease and frontotemporal dementia and no notable side effects were seen. In trial participants with frontotemporal dementia investigators also observed improved cognition.

Drug selection

To select the first two drugs for this trial, our scientists used an unbiased system to review all published research studies in MND and other neurodegenerative diseases and produced a list of drugs that may slow progression of MND. We looked at studies in other neurodegenerative diseases alongside MND studies as neurons may be affected in a similar way in these diseases to MND.

Next, we produced a shortlist of drugs based on how well the studies were conducted, and how effective and safe the drugs were.  A group of consultant neurologists then reviewed the shortlisted drugs and decided which were most likely to slow progression of MND alongside being able to be safely taken by people living with the disease. The two most promising drugs have been included in the trial.

Selecting more drugs for trial

MND-SMART is designed to run continuously for years to come to test treatments that may slow, stop or reverse the progression of MND. To help select future drugs we will trial, we will repeat the process of reviewing published information from MND and neurodegenerative disease studies at regular intervals to include the most recent published information. 

We want to keep improving this drug selection process and so are developing new computer programmes to make compiling and reviewing published studies more efficient. We are also working on gathering further information on how we can test the potential of shortlisted drugs. One way we are doing this is by testing them in our labs on stem cells derived from people with MND.