Effectiveness of a Medicine

For the treatment of choice or therapeutic method to prevent and must be based on a symptom of the disease or on objective data to prove its safety and effectiveness are based.

However, there are several levels of evidence. Only to be confirmed by a neighbor on the effectiveness of a medicine (evidence) is very weak evidence. The same statement from a large number of people are certainly more weight, but is still far from conclusive evidence that a particular approach has its supporters, although its usefulness is questionable goal.

The fact that treatment will be used for many years, even centuries, is not conclusive evidence of their effectiveness. Just think of the bloodshed, which was practiced thousands of years ago, but we now know to be dangerous and even deadly, because it weakens the already sick patient. However, since a long time this practice is effective and was used widely since ancient times to the twentieth century.

The Last Point

This last point is important because many drugs that act on the nervous system or immune system, including potentially serious side effects. Difficulty in MS is that, as is often remissions almost complete in the early stages of the disease, and that the intervals between outbreaks varies greatly (these intervals 30 years in some cases exceeded), it is very difficult to know what If the improvement of the clinical situation, which lasted for several years because of the effect of treatment or the occurrence of natural remission.

The minutes of the study double-blind placebo-controlled clinical study designed to provide a solution to this problem, both in medical and surgical care and rehabilitation for the treatment of "alternative". Another problem is the enormous cost pressure in the treatment of some new drugs. Economy is becoming increasingly important in the evaluation of therapeutic, and in spite of the discussions that were raised by the institution.

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Choice of Treatment

So far, we have evaluated the progress made in treatment, to change the course of the disease. But breakthroughs have been equally important in the last decade in the treatment of neurological symptoms and rehabilitation. Is the development of new drugs and new methods of management of drug-old. Has been confirmed by controlled studies on certain aspects of the rehabilitation of the nervous system also the effectiveness of this method in the treatment of MS

Evidence of the effectiveness and choice of treatment

As with other serious diseases, the clinical phenotype is highly variable, and there are two main problems in MS, which affects all aspects of treatment. First, the effectiveness of treatment is difficult to determine, it is not easy to prove that the potential beneficial effects for the treatment of a greater chance of having side effects.

Stress, Approach

Here, we must stress the very problem that the success of these approaches in the past few years. Clinical studies have shown that it is possible, in the course of the disease by two categories of drugs currently approved, or at least change in some countries: in the beta interferons and acetate glatiramer. We now know that this treatment is effective in part, is no longer justified, morally, to provide a large scale and over long periods of placebo-controlled clinical studies so far have been necessary to shed light on the effectiveness of new drugs.

While it may be of shorter duration studies are justified morally, but will not be useful to study chronic disease such as MS. Another strategy would be to compare the new therapy to treat the list, but such a study would provide results much more difficult to interpret and will be more expensive than the trials and placebo-controlled. Therefore, we must develop a new approach to clinical trials, and this is exactly the goal of international cooperation, carried out under the auspices of the International Federation of Multiple Sclerosis.

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Effectiveness of Treatment

This applies in particular to a form of MS through the relentless progress without setbacks and clear and specific products and is characterized by remissions, but also applies to other forms of MS. In addition, it is increasingly clear that the white matter that appear normal on the abnormalities in brain MRI, and often contains the structure of the chemical composition.

These developments have led to the discovery of new therapeutic strategies for more than 80 new drugs that are in the beginning of the 21 evaluation of a century.

We have already stated on the significant progress that MRI technology has enabled us to judge ourselves better, and the effectiveness of treatment to reduce disease activity. However, it is very difficult to determine the exact nature of the relationship between the activity of MS, for example, using magnetic resonance imaging, and to see a physical disability associated with the disease. Therefore, the clinical criteria must still play a role in evaluating the effectiveness of treatment. This evaluation was conducted double-blind clinical trials already in the large, placebo-controlled.

Techniques of Magnetic

The use of certain techniques of magnetic resonance have a better understanding of how to develop provided the lesions. Usually preceded by a new strain that rupture of local blood-brain barrier, which is associated with inflammation. Can be observed demyelination (which is the characteristic phenomenon of the disease MS) at the same time almost. After about a month, to ease the inflammation and the healing process gets under way, and what about the clinical remission. Over time, however, there are in most cases the accumulation of neurological deficits by the onset of disability.

We have found recently that the element of non-recovery of the deficit is mainly due to complete degeneration of nerve fibers, and these observations have important therapeutic implications.

As expected, showed the emergence of new technologies and better, and the unexpected complexity of the disease. For example, we now know that the lesions of MS do not have the detection of infections.

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Traditional Therapy

Internet is often the first place people go to for information. So, this is evidence not only in the form of traditional paper published, but also on the website of the International Federation of Multiple Sclerosis. Thanks to a copy on the Internet, and the reader can easily access the updates until the release of the new printed version.

The development of knowledge about MS is partly a result of breakthroughs in various medical specialties, the most important undoubtedly those made in the techniques of MRI (magnetic resonance imaging [MRI], and NMR spectroscopy [SRM]).

Investigations have shown in magnetic resonance in a series that disease activity ten times more common than previously thought, simply on the basis of the frequency of relapses. This observation has to check the development of ways to be suitable for effective treatments to reduce the number of new lesions in the central nervous system (CNS).