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.

This book comprehensively reviews the current state of clinical trial methods in multiple sclerosis treatment, providing investigators, sponsors and specialists with current knowledge of outcome measures and study designs for disease and symptom management. The status of the rapidly evolving field of disease-modifying drugs is presented, with emphasis on the most promising therapies currently being tested. Experts discuss disease and symptom management for MS subtypes, including neuromyelitis optica and pediatric MS. In addition, key scientific advances in MS pathology, genetics, immunology and epidemiology are presented. The fourth edition has been extensively revised, featuring more than 50% new material. All chapters have been substantially updated to provide current information on rapidly evolving topics and this volume contains 15 new chapters, reflecting the growth of the field in recent years. This book is an essential reference for practitioners caring for MS patients, investigators planning or conducting clinical trials, and clinical trial sponsors.

Since the publication of the previous edition of this volume, there has been substantial progress in a number of areas of multiple sclerosis (MS) research. Although immunosuppressive treatments continue to be developed and refined, more targeted immunomodulatory therapies are surfacing as we learn more about how the immune system works in health and disease. Multiple Sclerosis Therapeutics, Third Edition provides a comprehensive review of clinical trial methodology and therapeutic modalities in MS. This edition reflects current understanding of the pathophysiology of the disease and includes popular and emerging treatments. Topics include: Biomarkers in MS Pharmacogenomics Emerging therapeutic modalities such as natalizumab, T-cell-based and B-cell-based therapies, cytokine/chemokine-based therapies, statins, and 4-aminopyridine Neuroprotection The use of OCT and MRI to guide disease therapy Within the next several years, we will begin to discover the utility and the limitations of stem cells in the treatment of MS. It is likely that the next edition of this text will include clinical trial data that evaluate early attempts at nervous system regeneration in MS. Until that time occurs, this volume remains an essential resource for neurologists and anyone involved in the treatment of MS.