Multiple Sclerosis and Related Disorders (2015) 4, 181
Available online at www.sciencedirect.com
journal homepage: www.elsevier.com/locate/msard
Editors’ Welcome Let’s start with good news: all volumes of MSARD (going right back to the ﬁrst issues of 2012) are now indexed by the National Library of Medicine in PubMed; a major goal of the editors and publisher. In these days of proliferating medical journals, the ability to maintain and promote a high quality, scientiﬁcally sound relevant publication is challenging. Recognition by the major indexing services should help us maintain and improve upon that goal. In the last issue, Professor Kurtzke detailed the history and logic involved in the development of his eponymous disability scale. The importance of this metric in the evolution of MS therapeutics should not be underestimated. Subsequent difﬁculty in ﬁnding a replacement for use in clinical trials reﬂects the major contribution of this scale. In his manuscript Dr. Kurtzke raises concerns over the use of the EDSS in Neurostatus developed by Professor Kappos and colleagues and employed in the majority of pivotal MS clinical trials. In this issue of MSARD, the Neurostatus team provides us with a welcome history of the development of that tool and clariﬁcation of the proprietary issues raised by Dr. Kurtzke. The review of the origin of this scale and its derivations not only provides direct context for readers, but should guide those who are trying to design future, hopefully, enhanced measurements. It should be emphasized that there have been several versions of the EDSS (in addition to the original scale and Neurostatus) used in numerous clinical trials carried out since the late 1980’s. This issue of MSARD has three reviews: Dr. Zakaria provides a very useful and topical treatise on the “smoke and mirrors” of relapse rate reductions in MS clinical trials. He reminds us of the deﬁnitions for absolute and relative risk reductions and number need to treat. Most importantly, he explains why one cannot, and should not, compare these measures between studies; stressing the value of welldesigned head-to-head trials to determine relative efﬁcacy. In similar vein, Karabudak and colleagues review the strengths and weaknesses of clinical outcome measures that assess functional status in MS. The third review comes from the Multiple Sclerosis in the 21st Century Steering Group
http://dx.doi.org/10.1016/j.msard.2015.05.001 2211-0348/& 2015 Published by Elsevier B.V.
who discuss the importance and challenges of patient engagement and provide strategies for enhancing such interactions. Amongst our articles, Sawant, et al. review the application of transcutaneous nerve stimulation (TENS) for central pain in MS. Chouhfeh and colleagues compare the prevalence of co-existing autoimmune diseases in MS patients treated with disease-modifying agents and those untreated. Two papers come from the NARCOMS group; Nickerson et al. report on patient perceived impact of MS relapses and Fox and collaborators discuss the patient perspective on risk tolerance to MS therapies. Singhal and colleagues provide demographic data on MS at their institution in New Delhi, India and compare them to western datasets. They highlight both the importance of regional registries to characterize MS and the fact that MS is a global disease. Cortez, et al. discuss the impact of autonomic symptoms on quality of life in MS patients. Bellenberg and colleagues evaluate the relationship between cervical cord and infratentorial volume in relapsing forms of MS. Bermel and colleagues report on the apparent safety of administering SSRIs at ﬁngolimod initiation, utilizing a post hoc analysis of the pooled dataset from the ﬁngolimod clinical trials. We have 2 case reports. The ﬁrst, reported by Margolesky et al. describes transverse myelitis in a patient with HughesStovin syndrome. The second (McGovern et al.) discusses a potential association between use of interferon beta-1b and pulmonary hypertension. This issue has a wealth of informative material on MS and related conditions. Enjoy the read.
Editors in Chief Brenda Banwell Gavin Giovannoni Chris Hawkes Fred Lublin