What is a MAMS Trial?

A ‘multi-arm, multi-stage’ (MAMS) trial is an exciting new way to test treatments. MAMS trials test different treatments at the same time, in separate treatment groups. The treatments will be compared against a dummy drug (‘placebo’).

The treatments are checked at early stages to see if they appear to be working. Treatments that do appear to be working will keep going to the next testing stage (multi-stage), whilst treatments that do not appear to be working will be ended early.

This trial design also allows us to add new treatments in new treatment groups whilst the trial is ongoing, rather than needing to set up a new trial. This means that in one trial, we can get answers about many different treatments. This approach needs fewer participants, is cost-effective and faster compared to running multiple individual trials.

This diagram shows what the EJS ACT-PD study design looks like and when we expect each testing stage to happen, should each treatment continue to the end of the study.

Please note that:

• the image shows the full study length from opening to reporting the results. Each participant will only take part for a maximum of 36 months.

• the treatments shown in this image may end early if they do not pass the checks at each testing stage.

You can read more about MAMS Trials at the MRC CTU by visiting this page.

How was the trial designed?

The EJS ACT-PD Initiative has involved more than 100 members, all working together to transform clinical trials in Parkinson’s.

During the first stage of the initiative (2021–2024), six expert Working Groups were established, each focusing on a key aspect of developing the trial. These covered the overall trial design, the infrastructure needed to deliver the study, the outcome measures to be used, the selection of treatments to be tested, the funding required to run and sustain the trial, and most importantly patient and public involvement and engagement (PPIE) to ensure the trial was acceptable and meaningful.

Now that the trial has been built, the Initiative continues with four Working Groups focusing on trial innovation, the selection of future treatments including commercially produced compounds, the future funding of the trial and continued PPIE input on acceptability.

Our critical work was and is driven by our experts with experience, who contribute to all of the Working Groups involved. To design an inclusive trial which is accessible and relevant to the entire Parkinson’s community, we also actively sought and responded to diverse perspectives and needs.