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This combination therapy, consisting of the anti-malarial hydroxychloroquine and the antihypertensive indapamide, is being developed by the University of Calgary for the treatment of secondary progressive multiple sclerosis (SPMS). Hydroxychloroquine is a small molecule that inhibits microglial activation, thereby reducing neuroinflammation. Indapamide is a generic medication with antioxidant properties that scavenges hydroxyl radicals and protects neurons from oxidative stress, potentially through the inhibition of NADPH oxidase-mediated damage. By targeting multiple disease mechanisms including oxidative stress, neuronal damage, and activated microglia/macrophages, the combination aims to attenuate axonal injury and reduce the progression of disability. It is currently being evaluated in a Phase 2, open-label, single-arm futility trial.
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