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The Natural History of Multiple Sclerosis

  • Chapter
Treatment of Multiple Sclerosis

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

Abstract

It is necessary to understand the natural history of multiple sclerosis (MS) so that the results of clinical trials of experimental therapies can be interpreted. It is, in the final analysis, natural history studies that provide us with the data for rates of progression of disability and of survival in untreated patients, to which therapeutic trials are ultimately compared. Natural history data are used to determine sample sizes and provide us with the disability progression rates in untreated patients from which the magnitude of “placebo effects” in controlled clinical trials can be ascertained. For example, if we knew that 50% of an untreated population of relapsing MS patients deteriorated by a specified amount on an accepted measure of disability over 2 years, the sample size required to demonstrate confidently a designated percentage reduction (e.g., 50%) in this rate by a promising therapeutic agent could be calculated (see Chap. 4). Similarly, an estimate of the placebo effect could be made if the placebo-treated patients deteriorated less than otherwise properly matched and monitored untreated controls from natural history studies.

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Authors
  1. Donald E. Goodkin
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Editors and Affiliations

  1. Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic Foundation, 9500 Euclid Avenue, 44195-5244, Cleveland, OH, USA

    Richard A. Rudick MD  & Donald E. Goodkin MD  & 

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© 1992 Springer-Verlag London Limited

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Goodkin, D.E. (1992). The Natural History of Multiple Sclerosis. 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_2

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  • DOI: https://doi.org/10.1007/978-1-4471-3184-7_2

  • 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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