Lavery Amy M, Verhey Leonard H, Waldman Amy T
Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
The Pediatric Demyelinating Disease Program, Program in Neuroscience & Mental Health, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada M5G 1X8.
Mult Scler Int. 2014;2014:262350. doi: 10.1155/2014/262350. Epub 2014 May 4.
Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease that manifests as acute relapses and progressive disability. As a primary endpoint for clinical trials in MS, disability is difficult to both characterize and measure. Furthermore, the recovery from relapses and the rate of disability vary considerably among patients. Given these challenges, investigators have developed and studied the performance of various outcome measures and surrogate endpoints in MS clinical trials. This review defines the outcome measures and surrogate endpoints used to date in MS clinical trials and presents challenges in the design of both adult and pediatric trials.
多发性硬化症(MS)是一种慢性炎症性神经退行性疾病,表现为急性复发和进行性残疾。作为MS临床试验的主要终点,残疾既难以描述也难以测量。此外,患者从复发中恢复的情况以及残疾率差异很大。鉴于这些挑战,研究人员已经开发并研究了MS临床试验中各种结局指标和替代终点的表现。本综述定义了迄今为止MS临床试验中使用的结局指标和替代终点,并提出了成人和儿科试验设计中的挑战。