The Multi-Arm Multi-Stage (MAMS) trial platform is an innovative approach to clinical trials that may be used to speed up the trial delivery process in Parkinson’s.

In a traditional clinical trial design, a group of people are randomly assigned into two groups. A new treatment is then assessed in one group and compared against a control agent which is given to the other group. This is described as a two-arm trial.

However, there are challenges associated with this type of trial design. In many cases, participants often wait a long time for the results, only to discover that the new treatment is frequently no better than the control treatment.

This traditional clinical trial design can therefore lead to long, slow, and costly clinical trials, which is problematic, particularly when there are many new treatments to evaluate.

The Multi-Arm Multi-Stage (MAMS) trial platform is a bold attempt to speed up the trial delivery process in Parkinson’s.

The first part - 'Multi Arm' - refers to the approach allowing for multiple treatments to be assessed simultaneously, against a single control agent. By comparing multiple treatment arms, many new treatments can be considered in the same trial, meaning fewer patients are needed over a shorter time frame in comparison to setting up separate trials to assess each of the experimental treatments.

The second part of this approach – 'Multi Stage' – refers to the multiple stages of the trial which are compared with the control arm. This approach can then determine which treatments are not working. Early on in a MAMS trial, if any of the experimental treatment arms do not show promise based on predefined criteria, recruitment to these arms is stopped. This approach underlies the 'Multi Stage' part of the MAMS trial platform, and allows for resources to be directed towards the more promising experimental arms of the trial.  

The MAMS trial design therefore allows for a quicker and more efficient evaluation of multiple treatments under one study protocol, meaning participants and the scientific community both benefit as results arrive quicker.

The MAMS trial design has been successfully implemented in other disease areas, particularly oncology. In addition, The Cure Parkinson’s Trust (CPT) is part funding the Australian Parkinson’s Mission (APM) which will initially test four repurposed treatments from the international Linked Clinical Trials programme.