Doctors in Cambridge believe they are “on the brink of a new class of treatments” for multiple sclerosis (MS) after a trial in patients suggested nerve damage may be repaired.
The treatment involves combining the common diabetes drug, metformin, with clemastine, an antihistamine, to help repair myelin.
This is the protective membrane that wraps around nerve cells. It becomes damaged in MS and causes symptoms such as fatigue, pain, spasms and problems with walking.
Previous evidence from animal studies found metformin enhanced the effect of clemastine on myelin repair, but until now the two drugs have never been tested together in people.
Dr Nick Cunniffe, academic neurologist at the University of Cambridge, who led the latest CCMR-Two trial, said: “I am increasingly sure that remyelination is part of the solution to stopping progressive disability in MS.
“We still need to research the long-term benefits and side-effects before people with MS consider taking these drugs.
“But my instinct is that we are on the brink of a new class of treatments to stop MS progression, and within the next decade we could see the first licensed treatment that repairs myelin and improves the lives of people living with MS.”
Dr Emma Gray, director of research at the MS Society, which funded the trial, said: “These results are truly exciting, and could represent a turning point in the way MS is treated.
“We desperately need ways to protect nerves from damage and repair lost myelin, and this research gives us real hope that myelin repair drugs will be part of the armoury of MS treatments in the future.
“This research is the culmination of decades of research funded by MS Society supporters. We won’t stop until we find treatments for everyone living with MS.”
Some 70 people with relapsing MS took part in the six-month trial, with half given the drug combination and the other half given a placebo (dummy) drug.
Experts then measured how quickly signals travelled between the eyes and the brain.
The results suggested that, while the speed of signals slowed down in the placebo group over the course of six months, they remained constant in the drug group, suggesting a degree of boost to nerve function.
While people did not report actually feeling better on the drugs, no serious side-effects occurred.
Researchers also believe the benefit of myelin repair is to insulate and protect damaged nerves, preventing them from degenerating over years.
Therefore, drugs that promote remyelination will hopefully have an effect on disability in the longer-term, past the six months of the trial.
More than 150,000 people live with MS in the UK. While there are therapies that work on the immune system, none stop the gradual nerve damage that leads to long-term disability.
Hannah Threlfall, 43, from Abington was diagnosed with relapsing MS in 2019 and took part in the trial.
She said: “I love helping and I know being on this trial will make a difference to someone else in the future – even small ripples have long-lasting effects.
“It would mean everything to find a way to stop MS progressing and would be the answer to the prayer.
“This research gives me even more reason to believe that in my lifetime everyone with MS will have treatments that work for them.”
The trial results are being presented at the European Committee for Treatment and Research in Multiple Sclerosis in Barcelona on Friday.
The research is expected to be published in a peer-reviewed journal.
