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The primary clinical outcome measure for evaluating multiple sclerosis in clinical trials has been Kurtzke's expanded disability status scale (EDSS). New therapies appear to favourably impact the course of multiple sclerosis and render continued use of placebo control groups more difficult. Consequently, future trials are likely to compare active treatment(More)
BACKGROUND There is no consensus method for determining progression of disability in patients with multiple sclerosis (MS) when each patient has had only a single assessment in the course of the disease. METHODS Using data from two large longitudinal databases, the authors tested whether cross-sectional disability assessments are representative of disease(More)
Multiple sclerosis can follow very different patterns of evolution and variable rates of disability accumulation. This raises the issue whether it represents one or several distinct diseases. We assessed demographic and clinical characteristics in 1844 patients with multiple sclerosis that we categorized according to the classification of Lublin and(More)
The information of 349 cases of multiple sclerosis, seen in a neurological department over a twenty-year period and followed up for a mean of nine years, was analysed by computerized data processing. The mean age at onset was 30.0 years for the remittent onset types (82 per cent cases) and 37.3 years for the progressive onset types (18 per cent cases).(More)
Prognosis of multiple sclerosis is highly variable. Clinical variables have been identified that are assessable early in the disease and are predictors of the time from the disease onset to the onset of irreversible disability. Our objective was to determine if these clinical variables still have an effect after the first stages of disability have been(More)
BACKGROUND The influence of the patterns of onset of multiple sclerosis and relapses of the disease on the time course of irreversible disability is controversial. METHODS In 1844 patients with multiple sclerosis who were followed for a mean (+/- SD) of 11 +/- 10 years, we determined the time of the clinical onset of the disease, the initial course(More)
BACKGROUND AND METHODS Multiple sclerosis often occurs in young women, and the effect of pregnancy on the disease is poorly understood. We studied 254 women with multiple sclerosis during 269 pregnancies in 12 European countries. The women were followed during their pregnancies and for up to 12 months after delivery to determine the rate of relapse per(More)
BACKGROUND The course and prognosis of childhood-onset multiple sclerosis have not been well described. METHODS We used data from 13 adult neurology departments affiliated with the European Database for Multiple Sclerosis (EDMUS) network to identify a cohort of 394 patients who had multiple sclerosis with an onset at 16 years of age or younger and a(More)
BACKGROUND Interferon beta is used to modify the course of relapsing multiple sclerosis. Despite interferon beta therapy, many patients have relapses. Natalizumab, an alpha4 integrin antagonist, appeared to be safe and effective alone and when added to interferon beta-1a in preliminary studies. METHODS We randomly assigned 1171 patients who, despite(More)
OBJECTIVE To evaluate the efficiency of mitoxantrone in multiple sclerosis. METHODS Forty two patients with confirmed multiple sclerosis, selected as having a very active disease on clinical and MRI criteria were randomised to receive either mitoxantrone (20 mg intravenously (IV) monthly) and methylprednisolone (1 g iv monthly) or methylprednisolone alone(More)