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Sixty-two experienced multiple sclerosis(MS)investigators attending a research workshop were asked their opinion about clinical trial design, outcome measures,and treatment.Respondents favored repeated clinical observations of neurologic function(eg,Expanded Disability Status Scale or Ambulation Index)over the opinion of a blinded physician and changes on magnetic resonance imaging.There was agreement that stable MS should not be treated with immunosuppressives.Corticosteroids were rated the most effective treatment for recent disease activity.Total lymphoid irradiation and immunosuppressives were judged more potent for the long-term management of progressive disease.No treatment,however,received the support of more than 11%of the respondents for being of"considerable efficacy"in the long-term management of MS.Most favored a placebo- controlled design in the future trials.In order to judge the acceptability of current trial design,participants were asked to act as patient surrogates and to indicate whether they would agree to participate in 4 randomized trials for which they would be eligible.The majority consented to participate in the 3 major trials currently under way,and most refused to enroll in the 1 trial that had never been initiated. |
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immunosuppression
immunosuppressive agents
multiple sclerosis
multiple sclerosis,treatment of
radiation therapy,total body
review article
steroid
steroid therapy,CNS treatment and complications with
treatment of neurologic disorder
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