TY - JOUR T1 - Systematic approach to selecting licensed drugs for repurposing in the treatment of progressive multiple sclerosis JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 295 LP - 302 DO - 10.1136/jnnp-2020-324286 VL - 92 IS - 3 AU - Nick Cunniffe AU - Khue Anh Vuong AU - Debbie Ainslie AU - David Baker AU - Judy Beveridge AU - Sorrel Bickley AU - Patrick Camilleri AU - Matthew Craner AU - Denise Fitzgerald AU - Alerie G de la Fuente AU - Gavin Giovannoni AU - Emma Gray AU - Lorraine Hazlehurst AU - Raj Kapoor AU - Ranjit Kaur AU - David Kozlowski AU - Brooke Lumicisi AU - Don Mahad AU - Björn Neumann AU - Alan Palmer AU - Luca Peruzzotti-Jametti AU - Stefano Pluchino AU - Jennifer Robertson AU - Alan Rothaul AU - Lyndsey Shellard AU - Kenneth J Smith AU - Alastair Wilkins AU - Anna Williams AU - Alasdair Coles Y1 - 2021/03/01 UR - http://jnnp.bmj.com/content/92/3/295.abstract N2 - Objective To establish a rigorous, expert-led, evidence-based approach to the evaluation of licensed drugs for repurposing and testing in clinical trials of people with progressive multiple sclerosis (MS).Methods We long-listed licensed drugs with evidence of human safety, blood–brain barrier penetrance and demonstrable efficacy in at least one animal model, or mechanistic target, agreed by a panel of experts and people with MS to be relevant to the pathogenesis of progression. We systematically reviewed the preclinical and clinical literature for each compound, condensed this into a database of summary documents and short-listed drugs by scoring each one of them. Drugs were evaluated for immediate use in a clinical trial, and our selection was scrutinised by a final independent expert review.Results From a short list of 55 treatments, we recommended four treatments for immediate testing in progressive MS: R-α-lipoic acid, metformin, the combination treatment of R-α-lipoic acid and metformin, and niacin. We also prioritised clemastine, lamotrigine, oxcarbazepine, nimodipine and flunarizine.Conclusions We report a standardised approach for the identification of candidate drugs for repurposing in the treatment of progressive MS. ER -