Abstract
Feast or famine in multiple sclerosis therapeutics.
Highlights
MS-SMART models efficient trial design by comparing three active treatment arms with placebo
Over the past 30 years, the number of drugs approved for multiple sclerosis has gone from zero to more than 15, with several dosing variations and generic versions
Current multiple sclerosis treatments seem to predominantly benefit the inflammatory lesion activity that underlies relapsing multiple sclerosis, leaving the progressive aspects mostly unabated
Summary
MS-SMART models efficient trial design by comparing three active treatment arms with placebo. Treatments for patients with progressive multiple sclerosis who do not have active disease are scarce. The authors selected three experi mental drugs (amiloride, fluoxetine, and riluzole) for MS-SMART that were identified by extensive systematic review of 532 treatment candidates.[4] These drugs target axonal pathobiology and neuroprotection, and have extensive evidence of use in humans with estab lished safety profiles, so were ready for trial testing in progressive multiple sclerosis.
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