Assessing treatment outcomes in multiple sclerosis trials and in the clinical setting

Carmen Tur, Marcello Moccia, Frederik Barkhof, Jeremy Chataway, Jaume Sastre-Garriga, Alan J. Thompson, Olga Ciccarelli*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Increasing numbers of drugs are being developed for the treatment of multiple sclerosis (MS). Measurement of relevant outcomes is key for assessing the efficacy of new drugs in clinical trials and for monitoring responses to disease-modifying drugs in individual patients. Most outcomes used in trial and clinical settings reflect either clinical or neuroimaging aspects of MS (such as relapse and accrual of disability or the presence of visible inflammation and brain tissue loss, respectively). However, most measures employed in clinical trials to assess treatment effects are not used in routine practice. In clinical trials, the appropriate choice of outcome measures is crucial because the results determine whether a drug is considered effective and therefore worthy of further development; in the clinic, outcome measures can guide treatment decisions, such as choosing a first-line disease-modifying drug or escalating to second-line treatment. This Review discusses clinical, neuroimaging and composite outcome measures for MS, including patient-reported outcome measures, used in both trials and the clinical setting. Its aim is to help clinicians and researchers navigate through the multiple options encountered when choosing an outcome measure. Barriers and limitations that need to be overcome to translate trial outcome measures into the clinical setting are also discussed.

Original languageEnglish
Pages (from-to)75-93
Number of pages19
JournalNature Reviews Neurology
Volume14
Issue number2
DOIs
Publication statusPublished - 1 Feb 2018

Cite this

Tur, C., Moccia, M., Barkhof, F., Chataway, J., Sastre-Garriga, J., Thompson, A. J., & Ciccarelli, O. (2018). Assessing treatment outcomes in multiple sclerosis trials and in the clinical setting. Nature Reviews Neurology, 14(2), 75-93. https://doi.org/10.1038/nrneurol.2017.171