St George's Hospital has become the first hospital in London to start open an innovative motor neurone disease (MND) trial.

The trial, called MND-SMART, is now open to opening to people of London and is recruiting people living with MND to take part in tests of potential treatments.

Unlike other trials which test a single treatment at a time, MND-SMART is testing multiple drugs and hopes to speed up the time it takes to find effective medicines that can slow the progression of MND.

MND, also known as amyotrophic lateral sclerosis or ALS, is an incurable progressive condition that causes muscle to waste away. It occurs when nerve cells called motor neurons, which send messages from the brain and spinal cord to the body's muscles, stop working properly.

More than 1500 people are diagnosed with MND in the UK each year. There is no cure and half of people die within two years of diagnosis.

Dr Pablo Garcia-Reitboeck, Consultant Neurologist and Principal Investigator for the study at St George's, said: "This is St George's first ever drug trial for patients with motor neurone disease. What excites me most about the trial is the innovative design and the fact that multiple drugs can be tested over time.

"It's a much quicker way of helping us to find a treatment for the condition, compared to a traditional trial design which would test one drug at a time. My hope is that it brings us one step closer to finding a treatment for motor neurone disease."

Eoin Egan, 39, from Wandsworth, is one of the first patients to be taking part in the trial at St George's. Eoin was referred to St George's neurology team in 2019 after experiencing persistent twitching in his arms and legs.

Eoin had also developed foot drop, which is a muscular weakness or paralysis that makes it difficult to lift the front part of your foot and toes. Following various tests, Dr Pablo Garcia-Reitboeck diagnosed Eoin with MND.

"I didn't know much about the condition, but I knew it was quite serious when Dr Garcia-Reitboeck asked me to bring my wife in too," said Eoin. "I didn't understand how progressive it was at the time, but he was very open about it and gave me all the facts I needed."

Since being diagnosed with MND, Eoin has been researching clinical trials for the condition.

"The sheer quantity of trials and research that is happening right now is far more than has happened throughout history," said Eoin. "Even though there is no guarantee, I do pick up on a lot of hope in the medical research community.

"I was immediately very keen to take part in the MND-SMART trial when I was invited. I understand that people need to do these trials in order to progress a solution to MND. And I'm very happy and proud to be a part of trying to do that."

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

The first drug, memantine, is already used to improve the memory of people with Alzheimer's disease by reducing the action of a brain chemical called glutamate. It's thought that this drug may slow the damage to neurons in people with MND.

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.

MND-SMART is one of a limited number of clinical studies that has managed to continue during the coronavirus pandemic, although the pace of recruitment has been affected. A number of different factors contributed to the trial continuing. These included an innovative trial design, allowing video call appointments and couriered drugs.

People with MND who have already registered their interest in taking part in the trial at www.mnd-smart.org do not need to sign up again.

The trial has been developed by people with MND and clinical trial experts from across the UK. The study is led by the Euan MacDonald Centre for MND Research at the University of Edinburgh.

MND-SMART is funded by MND Scotland, Euan MacDonald Centre and the My Name'5 Doddie Foundation.

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