Defining the clinical course of multiple sclerosis
Abstract
Accurate clinical course descriptions (phenotypes) of multiple sclerosis (MS) are important for communication, prognostication, design and recruitment of clinical trials, and treatment decision-making. Standardized descriptions published in 1996 based on a survey of international MS experts provided purely clinical phenotypes based on data and consensus at that time, but imaging and biological correlates were lacking. Increased understanding of MS and its pathology, coupled with general concern that the original descriptors may not adequately reflect more recently identified clinical aspects of the disease, prompted a re-examination of MS disease phenotypes by the International Advisory Committee on Clinical Trials of MS. While imaging and biological markers that might provide objective criteria for separating clinical phenotypes are lacking, we propose refined descriptors that include consideration of disease activity (based on clinical relapse rate and imaging findings) and disease progression. Strategies for future research to better define phenotypes are also outlined.
MeSH terms
Funding
- National Multiple Sclerosis Society
- Eli Lilly and Company
- Pfizer
- Amylin Pharmaceuticals
- GlaxoSmithKline
- Sanofi
- Gilead Sciences
- Biogen
- Teva Pharmaceutical Industries
- Alexion Pharmaceuticals
- Celgene
- F. Hoffmann-La Roche
- Cleveland Clinic
- Novartis Pharmaceuticals Corporation
- University of Alabama at Birmingham
- European Committee for Treatment and Research in Multiple Sclerosis
- Wellcome Trust
- Ironwood Pharmaceuticals, Incorporated
- University of Alabama
- Myelin Repair Foundation
- University of Texas Health Science Center at Houston
- GW Pharmaceuticals
- Acorda Therapeutics
- Prothena
- Glenmark Pharmaceuticals
- National Institute for Health and Care Research
- Multiple Sclerosis Society
- University of Cambridge
- European Commission
- Bayer HealthCare
- Wolfson Foundation
- National Research Foundation
- Eisai
- Multiple Sclerosis International Federation
- Schweizerische Multiple Sklerose Gesellschaft
- Sun Pharma
- Serono Symposia International Foundation
- Grifols
- National Institutes of Health
- Genentech
- EMD Serono
- Bayer Canada
- Sanofi Genzyme
- Canadian Institutes of Health Research
- Natural Sciences and Engineering Research Council of Canada
- Medical Research Council
- National Heart, Lung, and Blood Institute
- National Institute of Neurological Disorders and Stroke
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