Measuring treatment response in progressive multiple sclerosis—considerations for adapting to an era of multiple treatment options
Biomolecules, ISSN: 2218-273X, Vol: 11, Issue: 9
2021
- 6Citations
- 34Captures
- 1Mentions
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
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Metrics Details
- Citations6
- Citation Indexes6
- CrossRef6
- Captures34
- Readers34
- 34
- Mentions1
- Blog Mentions1
- Blog1
Review Description
Disability in multiple sclerosis accrues predominantly in the progressive forms of the dis-ease. While disease‐modifying treatment of relapsing MS has drastically evolved over the last quar-ter‐century, the development of efficient drugs for preventing or at least delaying disability in progressive MS has proven more challenging. In that way, many drugs (especially disease‐modifying treatments) have been researched in the aspect of delaying disability progression in patients with a progressive course of the disease. While there are some disease‐modifying treatments approved for progressive multiple sclerosis, their effect is moderate and limited mostly to patients with clinical and/or radiological signs of disease activity. Several phase III trials have used different primary outcomes with different time frames to define disease progression and to evaluate the efficacy of a disease‐modifying treatment. The lack of sufficiently sensitive outcome measures could be a possible explanation for the negative clinical trials in progressive multiple sclerosis. On the other hand, even with a potential outcome measure that would be sensitive enough to determine disease progression and, thus, the efficacy or failure of a disease‐modifying treatment, the question of clinical relevance remains unanswered. In this systematic review, we analyzed outcome measures and def-initions of disease progression in phase III clinical trials in primary and secondary progressive multiple sclerosis. We discuss advantages and disadvantages of clinical and paraclinical outcome measures aiming for practical ways of combining them to detect disability progression more sensi-tively both in future clinical trials and current clinical routine.
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