Multiple sclerosis is one of the major current problems in neurol ogical practice. It remains incompletely understood, yet is a common cause of chronic disability in developed Western so cieties: Patients with the disease have difficulty understanding what has happened to them and become bewildered by the con trast between the evidently large body of knowledge concerning the clinical manifestations and course of the disease, and the conflicting views they so often receive from different specialists as to the best current management of their disease. As in so many disorders for which treatment is only partially effective, at best, "alternative" therapies abound. Dr. Rudick and Dr. Goodkin have extensive experience in the day-to-day management of multiple sclerosis at the Mellen Center for Multiple Sclerosis Treatment and Research, attached to the Cleveland Clinic. In this book they have assembled a group of experts from several countries and have provided a comprehensive review of the results of different treatments of the disease. Each treatment is considered in the light of its proposed scientific basis or mode of action, and in relation to ethical and trial design issues. This information deserves to be made widely available. As the treatment of multiple sclerosis enters a new era as a result of the new understanding of the cellular mechanisms of demyelination and the molecular biology of the immune response, this information about current treatments assumes additional importance. The book is of interest to all physicians concerned with the management of patients with the disease.

Multiple Sclerosis: Advances in Clinical Trial Design, Treatment and Future Perspectives is a review of therapeutic developments for a disease that is one of the major problems in current neurologic practice. Progress in this field has been rapid and there have been important developments in clinical trial design and a number of important trial results that have resulted in new treatment options for patients and physicians. Important ethical considerations that arise with new treatments are included, as is a perspective on the emergence of MS as a treatable disease. This book is for all neurologists, primary care physicians, and patients concerned about the treatment of MS. It will also be of value to clinical epidemiologists and biostatisticians with an interest in experimental therapies for chronic disease, to immunologists with an interest in autoimmune disease, to the pharmaceutical industry and to MS societies.