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Primary Progressive Multiple Sclerosis (Paperback, Softcover reprint of the original 1st ed. 2002)
Loot Price: R1,493
Discovery Miles 14 930
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Primary Progressive Multiple Sclerosis (Paperback, Softcover reprint of the original 1st ed. 2002)
Series: Topics in Neuroscience
Expected to ship within 10 - 15 working days
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"Why are there no effective treatments for my condition? Why do
researchers exclude patients with primary progressive multiple
sclerosis from enrolling in clinical trials? Please let me know if
you hear of studies that I might be allowed to enter or treatments
that I could try for my condition. " Thus, in recent years, the sad
lament of the patient with primary progressive MS (PPMS). This
variant, often in the guise of a chronic progressive myelopathy or,
less commonly, progressive cerebellar or bulbar dysfunction,
usually responds poorly to corticosteroids and rarely seems to
benefit to a significant degree from intensive immunosuppressive
treatments. In recent years, most randomized clin ical trials have
excluded PPMS patients on two counts. Clinical worsening devel ops
slowly in PPMS and may not be recognized during the course of a
2-or 3-year trial even in untreated control patients. This factor
alone adds to the potential for a type 2 error or, at the very
least, inflates the sample size and duration of the trial. In
addition, there is mounting evidence that progressive axonal
degeneration and neuronal loss (rather than active, recurrent
inflammation) may be important components of the pathology in this
form of the disease. Although contemporary trials are evaluating
whether PPMS patients may benefit from treatment with the
~-interferons and glatiramer acetate, preliminary, uncontrolled
clinical experi ence suggests that the results may not be dramatic.
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