Multiple Sclerosis Clinical Trials in the UK (2026)
Multiple sclerosis affects approximately 150,000 people in the UK. The treatment landscape has transformed over the past decade with the arrival of highly effective disease-modifying therapies (DMTs), but significant unmet need remains — particularly for progressive forms of MS and for remyelination. This guide covers the main types of MS trials currently recruiting in the UK.
Current MS Research Areas
One of the most active areas in MS research. BTK inhibitors (tolebrutinib, evobrutinib, fenebrutinib) can cross the blood-brain barrier, targeting microglial activation in addition to B-cells. Multiple Phase 3 trials are recruiting in relapsing and progressive MS through UK sites.
Trials testing drugs that stimulate oligodendrocytes to form new myelin sheaths around damaged nerve fibres. These are potentially disease-modifying for all MS subtypes. OPC1 (oligodendrocyte progenitor cell therapy) and clemastine derivatives are in clinical trials.
New monoclonal antibodies targeting CD52, CD20, or IL-2 pathways, including biosimilars to expand access. Trials also test different dosing intervals and sequencing strategies to balance efficacy with safety.
Trials focused on preserving nerve cells and axons, independent of immune modulation. Strategies include sodium channel blockers, mitochondrial enhancers, and iron chelation for paramagnetic rim lesions.
MS Subtypes and Trial Eligibility
- Clinically Isolated Syndrome (CIS) — Early treatment trials aiming to delay conversion to definite MS
- Relapsing-Remitting MS (RRMS) stabilised on DMT — Tests of switching to higher-efficacy therapy or extended interval dosing
- Active Secondary Progressive MS (SPMS) — Requires evidence of recent relapses or MRI activity plus confirmed disability progression
- Non-active SPMS and Primary Progressive MS (PPMS) — The greatest unmet need. Trials testing BTK inhibitors, remyelination agents, and neuroprotective strategies
- Highly active MS — Trials for patients with breakthrough disease despite high-efficacy DMTs
Key Trial Requirements
- Confirmed MS diagnosis by McDonald criteria
- EDSS score (Expanded Disability Status Scale) — typically 0-6.5 for most trials
- Recent MRI brain showing disease activity (new/enlarging T2 lesions or gadolinium-enhancing lesions) — required for relapsing MS trials
- Stable MS symptoms — no recent relapse within 30-60 days before screening
- JCV antibody index — required for any trial involving natalizumab or similar agents (PML risk assessment)
- Prior treatment history and washout periods for previous DMTs
Tip: MS trials often require an MRI scan within a specific window. If you have recent MRI results, bring them to your trial screening visit. Our Smart Matcher can help you find trials based on your MS subtype and current DMT.
UK MS Trial Network
The UK has a well-established MS clinical trial network through centres including:
- London — Queen Square (UCL Institute of Neurology), St George's, King's College Hospital
- Cambridge — Addenbrooke's Hospital, Anne McLaren Laboratory
- Edinburgh — Anne Rowling Regenerative Neurology Clinic
- Manchester — Salford Royal NHS Foundation Trust
- Birmingham — Queen Elizabeth Hospital
- Glasgow — Queen Elizabeth University Hospital
- Nottingham — Nottingham University Hospitals
What to Expect on an MS Trial
- Regular MRI scans (typically 3-12 monthly depending on the trial)
- EDSS assessments by a trained assessor
- Blood monitoring for safety and biomarkers
- Trial medication, infusions, or injections provided free
- Regular neurology review with the trial team
- Most trials reimburse travel expenses
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