Abstract
While it is logical that definitiv ee valuation of new therapies is based on clinical outcomes, there are major difficulties in conducting treatment trials in multiple sclerosis (MS) with clinical endpoints such as relapse rate or disability progression. The slow clinical evolution requires large studies (several hundred patients) of long duration (2 � /3 years), with an active treatment group being compared to a control group. It is thus not surprising that there has been much effort to identify alternative measures of disease activity to monitor treatment efficacy. To be an effective replacement, or surrogate, of clinical outcomes, the measure of disease activity should be objective, sensitive, accurate, and reproducible. Most importantly, it should reflect and predict a clinically meaningful outcome. This review considers the role of magnetic resonance (MR) techniques in monitoring MS clinical trials. Because serial MRI has become a mandatory part of therapeutic monitoring, and because the effects of new therapies on MR outcomes have been very influential in conditioning the use of treatments in practice, an appraisal of its role in this setting is appropriate. 2. Potential of MRI as a tool to monitor treatment
Published Version
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