The natural history of multiple sclerosis: a geographically based study. 5. The clinical features and natural history of primary progressive multiple sclerosis.

@article{Cottrell1999TheNH,
  title={The natural history of multiple sclerosis: a geographically based study. 5. The clinical features and natural history of primary progressive multiple sclerosis.},
  author={Daryl A. Cottrell and Marcelo Kremenchutzky and George P. Rice and Wilma J Koopman and Walter J Hader and Jon C. Baskerville and George Cornell Ebers},
  journal={Brain : a journal of neurology},
  year={1999},
  volume={122 ( Pt 4)},
  pages={
          625-39
        }
}
We report a natural history study of 216 patients with primary progressive (PP)- multiple sclerosis defined by at least 1 year of exacerbation-free progression at onset. This represents 19.8% of a largely population-based patient cohort having a mean longitudinal follow-up of 23 years. This subgroup of PP-multiple sclerosis patients had a mean age of onset of 38.5 years, with females predominating by a ratio of 1.3:1.0. The rate of deterioration from disease onset was substantially more rapid… 
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  • Medicine, Psychology
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  • 2005
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TLDR
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TLDR
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Background: Primary progressive multiple sclerosis (PPMS) has a distinct clinical phenotype and has historically been understudied with few longitudinal natural history studies spanning a reasonable
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It is expected that the considerations outlined here will prove useful for both trial design and interpretation of trials in PP-multiple sclerosis which will require multi-centre collaborative efforts.
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