Visual outcome measures in clinical trials of remyelinating drugs

Gioia Riboni-Verri; Benson S Chen; Christopher E McMurran; Gregory J Halliwell; J William L Brown; Alasdair J Coles; Nick G Cunniffe

doi:10.1136/bmjno-2023-000560

Visual outcome measures in clinical trials of remyelinating drugs

BMJ Neurol Open. 2024 Feb 19;6(1):e000560. doi: 10.1136/bmjno-2023-000560. eCollection 2024.

Authors

Gioia Riboni-Verri^{1

2}, Benson S Chen^{1

2}, Christopher E McMurran^{1

2

3}, Gregory J Halliwell¹, J William L Brown^{1

4}, Alasdair J Coles^{1

2}, Nick G Cunniffe^{1

2}

Affiliations

¹ Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
² Cambridge Clinical Vision Laboratory, University of Cambridge, Cambridge, UK.
³ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
⁴ Clinical Outcomes Research Unit (CORe), University of Melbourne, Melborune, Melborune, Australia.

Abstract

One of the most promising approaches to delay, prevent or reverse disability progression in multiple sclerosis (MS) is to enhance endogenous remyelination and limit axonal degeneration. In clinical trials of remyelinating drugs, there is a need for reliable, sensitive and clinically relevant outcome measures. The visual pathway, which is frequently affected by MS, provides a unique model system to evaluate remyelination of acute and chronic MS lesions in vivo and non-invasively. In this review, we discuss the different measures that have been used and scrutinise visual outcome measure selection in current and future remyelination trials.

Keywords: CLINICAL NEUROLOGY; MULTIPLE SCLEROSIS; MYELIN; NEUROOPHTHALMOLOGY; VISUAL EVOKED POTENTIALS.

Publication types

Review