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Experimental Therapies for Multiple Sclerosis: Historical Perspective

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Treatment of Multiple Sclerosis

Part of the book series: Clinical Medicine and the Nervous System ((CLIN.MED.NERV.))

Abstract

My task is to describe the evolution over the past 20 years of clinical trial designs in multiple sclerosis to their current state; to list major milestones as I see them; and to point out past, present, and future difficulties. From other chapters of the book, I have selected examples of milestones reached, and of problems solved and to be solved by future clinical trialists.

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References

  • Bornstein MB, Miller A, Slagle S et al. (1987) A pilot trial of Cop 1 in exacerbating-remitting multiple sclerosis. N Engl J Med 317: 408–414

    Article  PubMed  CAS  Google Scholar 

  • British and Dutch Multiple Sclerosis Azathioprine Trial Group (1988) Double-masked trial of azathioprine in multiple sclerosis. Lancet 2: 179–183

    Google Scholar 

  • Broman T (1970) Management of patients with multiple sclerosis. In: Vinken PJ, Bruyn GW (eds) Multiple sclerosis and other demyelinating diseases. North-Holland Publishing Company, Amsterdam, pp 408–425 (Handbook of clinical neurology, vol 9 )

    Google Scholar 

  • Brown JR, Beebe GW, Kurtzke JF, Loewenson RB, Silberberg DH, Tourtellotte WW (1979) The design of clinical studies to assess therapeutic efficacy in multiple sclerosis. Neurology 29: 1–23

    Google Scholar 

  • Detels R, Clark VA, Valdiviezo NL, Visscher BR, Malmgren RM, Dudley JP (1982) Factors associated with a rapid course of multiple sclerosis. Arch Neurol 39: 337–341

    PubMed  CAS  Google Scholar 

  • Detsky AS (1985) When was a negative clinical trial big enough? How many patients you needed depends on what you found. Arch Intern Med 145: 709–712

    Article  PubMed  CAS  Google Scholar 

  • DHEW 1974 — US Department of Health, Education, and Welfare (February 11, 1974 ) National Advisory Commission on Multiple Sclerosis, Report and Recommendations. HEW, Public Health Service, National Institutes of Health, Washington DC, Publication # (NIH) 74–534: 36–38

    Google Scholar 

  • DHEW 1977 — US Department of Health, Education, and Welfare, Food and Drug Administration (September 1977) General considerations for the clinical evaluation of drugs. US Government Printing Office, Washington DC, HEW (FDA) 77–3040: 6–11

    Google Scholar 

  • DHEW 1979 — US Department of Health, Education, and Welfare. Public Health Service, National Institutes of Health. National Institute of Neurological and Communicative Disorders and Stroke (1979) Report of the panel on inflammatory, demyelinating, and degenerative diseases to the national advisory neurological and communicative disorders and stroke council. Washington DC, NIH Publication No. 79–1916: 24–30

    Google Scholar 

  • Ellison GW, Myers LW (1980) Immunosuppressive drugs in multiple sclerosis: pro and con. Neurology 30 (7 Pt 2): 28–32

    PubMed  CAS  Google Scholar 

  • Ellison GW, Myers LW, Mickey MR et al. (1983) Multiple sclerosis: patient accrual problems in a therapeutic trial. Neurology 33 (suppl 2): 71

    Google Scholar 

  • Ellison GW, Mickey MR, Myers LW (1988) Alternatives to randomized clinical trials. Neurology 38 (7 Suppl 2): 73–75

    PubMed  CAS  Google Scholar 

  • Ellison GW, Myers LW, Mickey MR et al. (1989) A placebo-controlled, randomized, double-masked, variable dosage, clinical trial of azathioprine with and without methylprednisolone in multiple sclerosis. Neurology 39: 1018–1026

    PubMed  CAS  Google Scholar 

  • Goodkin DE, Bailly R, Teetzen M, Hertsgaard D (1991) The efficacy of azathioprine in relapsing-remitting multiple sclerosis. Neurology 41: 20–25

    PubMed  CAS  Google Scholar 

  • Hauser SL, Dawson DM, Lehrich JR et al. (1983) Intensive immunosuppression in progressive multiple sclerosis. A randomized, three-arm study of high-dose intravenous cyclophosphamide, plasma exchange, and ACTH. N Engl J Med 308: 173–180

    Article  PubMed  CAS  Google Scholar 

  • Herndon RM, Murray TJ (1983) Proceedings of the international conference on therapeutic trials in multiple sclerosis. Arch Neurol 40: 663–710

    Google Scholar 

  • Hommes OR, Prick JJG, Lamers KJB (1975) Treatment of the chronic progressive form of multiple sclerosis with a combination of cyclophosphamide and prednisone. Clin Neurol Neurosurg 78: 59–72

    Article  PubMed  CAS  Google Scholar 

  • Hulley SB, Cummings SR (1988) Designing clinical research. Williams and Wilkins, Baltimore IFMSS (International Federation of Multiple Sclerosis Societies) (1982) Therapeutic claims in multiple sclerosis. National Multiple Sclerosis Society, New York

    Google Scholar 

  • Johnson KP (1983) Systemic interferon therapy for multiple sclerosis. Design of a trial. Arch Neurol 40: 681–682

    PubMed  CAS  Google Scholar 

  • Johnson MA, Li DKB, Bryant DJ, Payne JA (1984) Magnetic resonance imaging: serial observation in multiple sclerosis. AJNR 5: 495–499

    PubMed  CAS  Google Scholar 

  • Knobler RL, Panitch HS, Braheny SL et al. (1984) Systemic alpha-interferon therapy of multiple sclerosis. Neurology 34: 1273–1279

    PubMed  CAS  Google Scholar 

  • Kurtzke JF (1983) Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS). Neurology 33: 1444–1452

    PubMed  CAS  Google Scholar 

  • Kurtzke JF (1986) Neuroepidemiology. Part II. Assessment of therapeutic trials. Ann Neurol 19: 311–319

    Article  PubMed  CAS  Google Scholar 

  • Kurtzke JF (1987) Problems and pitfalls in treatment trials of multiple sclerosis. Neuroepidemiology 6: 17–33

    Article  PubMed  CAS  Google Scholar 

  • Li D, Mayo J, Fache S, Robertson WD, Paty D, Genton M (1984) Early experience in nuclear magnetic resonance imaging of multiple sclerosis. Ann NY Acad Sci 436: 484–486

    Article  Google Scholar 

  • McAlpine D, Compston N (1952) Some aspects of the natural history of disseminated sclerosis. Q J Med 21: 135–167

    PubMed  CAS  Google Scholar 

  • McAlpine D, Compston ND, Lumsden CE (1955) Multiple sclerosis. Livingstone, Edinburgh, p 139

    Google Scholar 

  • McAlpine D, Lumsden CE, Acheson ED (1972) Multiple sclerosis, a reappraisal. Williams and Wilkins, Baltimore, pp 197–223

    Google Scholar 

  • Miller AE, Bornstein M, Slagle S et al. (1989) Clinical trial of Copl in chronic-progressive multiple sclerosis. Neurology 39 (suppl 1): 356–357

    Google Scholar 

  • Myers LW, Ellison GW (1988) Rationale for immunomodulating therapies of multiple sclerosis. Neurology 38 (7, Suppl 2): 4–89

    Google Scholar 

  • Poser CM, Paty DW, Scheinberg L et al. (1983) New diagnostic criteria for multiple sclerosis: Guidelines for research protocols. Ann Neurol 13: 227–231

    Article  PubMed  CAS  Google Scholar 

  • Rose AS, Kuzma JW, Kurtzke JF, Namerow NS, Sibley WA, Tourtellotte WW (1970) Cooperative study in the evaluation of therapy in multiple sclerosis: ACTH vs. placebo. Final Report. Neurology 20: 1–59

    PubMed  CAS  Google Scholar 

  • Schumacher GA, Beebe G, Kibler RE et al. (1965) Problems of experimental trials of therapy in multiple sclerosis: report by the panel on evaluation of experimental trials of therapy in multiple sclerosis. Ann NY Acad Sci 122: 552–568

    Article  Google Scholar 

  • Sibley WA, and the Therapeutic Claims Committee of the International Federation of Multiple Sclerosis (1988) Therapeutic claims in multiple sclerosis (2nd edn). Demos Publications, New York, pp vii-x, 1–198

    Google Scholar 

  • The Canadian Cooperative Multiple Sclerosis Study Group (1991) The Canadian cooperative trial of cyclophosphamide and plasma exchange in progressive multiple sclerosis. Lancet 337: 441–446

    Google Scholar 

  • The MS (Multiple Sclerosis) Study Group (1990) Efficacy and toxicity of cyclosporine in chronic progressive multiple sclerosis: randomized, double-blind, placebo-controlled clinical trial. Ann Neurol 127: 591–605

    Article  Google Scholar 

  • VAMS (Veterans Administration Multiple Sclerosis) Study Group (1957) Isoniazid in treatment of multiple sclerosis. Report on Veterans Administration Cooperative Study. JAMA 163: 168–172

    Google Scholar 

  • Weiner HL, Ebers GC (1983a) Development of simple trial protocols. Arch Neurol 40: 700–703

    PubMed  CAS  Google Scholar 

  • Weiner HL, Ellison GW (1983b) A working protocol to be used as a guideline for trials in multiple sclerosis. Arch Neurol 40: 704–710

    PubMed  CAS  Google Scholar 

  • Weiner HL, Dau P, Khatri B et al. (1989) Double-blind study of true versus sham plasma exchange in patients being treated with immunosuppression for acute attacks of multiple sclerosis. Neurology 39: 1143–1149

    PubMed  CAS  Google Scholar 

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© 1992 Springer-Verlag London Limited

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Ellison, G.W. (1992). Experimental Therapies for Multiple Sclerosis: Historical Perspective. In: Rudick, R.A., Goodkin, D.E. (eds) Treatment of Multiple Sclerosis. Clinical Medicine and the Nervous System. Springer, London. https://doi.org/10.1007/978-1-4471-3184-7_1

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  • DOI: https://doi.org/10.1007/978-1-4471-3184-7_1

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-3186-1

  • Online ISBN: 978-1-4471-3184-7

  • eBook Packages: Springer Book Archive

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