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The treatment of multiple sclerosis: current and future
1Department of Neurology, Free University Hospital, Amsterdam, The Netherlands.
Current Opinion in Neurology
|June 1, 1995
Summary
Future multiple sclerosis clinical trials should incorporate blinded investigators and magnetic resonance imaging. Several treatments show promise for relapsing-remitting and secondary progressive forms, but options for primary progressive multiple sclerosis remain limited.
Area of Science:
- Neurology
- Clinical Trials
Background:
- Recent clinical trial observations and results offer insights for improving multiple sclerosis (MS) trial design and treatment strategies.
- Evidence suggests several treatments may benefit patients across different phases of multiple sclerosis.
Purpose of the Study:
- To outline recommendations for future multiple sclerosis clinical trial design.
- To review current therapeutic options for various multiple sclerosis subtypes.
Main Methods:
- Proposes incorporating blinded investigators focused on clinical outcomes.
- Recommends including magnetic resonance imaging (MRI) for objective disease assessment.
- Suggests considering composite outcome variables for chronic progressive MS trials.
Main Results:
- Interferon beta-1a, interferon beta-1b, and copolymer-1 demonstrate partial efficacy in relapsing-remitting MS.
- Low-dose methotrexate and cladribine show potential benefits for secondary progressive MS.
- 4-aminopyridine and tizanidine may offer symptomatic relief for neurological deficits and spasticity, respectively.
Conclusions:
- Future MS trials require enhanced design elements, including blinded assessments and objective imaging.
- While treatments exist for certain MS forms, therapeutic options for primary progressive MS are currently limited.
- Symptomatic treatments show promise for managing specific MS-related issues.