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Can the course of multiple sclerosis be modified?
  1. Alasdair Coles
  1. University Lecturer and Consultant Neurologist, Department of Clinical Neuroscience, Box 165, Addenbrooke’s Hospital, Hills Road, Cambridge, UK, CB2 2QQ; E-mail: ajc1020{at}



In the conference hall, in an attractive foreign location, it is easy to be seduced into believing that our current licensed therapies for multiple sclerosis (MS) offer dramatic benefits to people with the disease. And patients who lived through the hullabaloo over the licensing, approval and funding of the interferons, are naturally inclined to have great expectations for their efficacy. But sitting in an MS clinic is a sobering experience. Interferons are seen to be as efficacious in controlling relapses as some of the minor antiepileptic drugs are in reducing seizures. More worryingly, the reasonable questions asked by patients are at present unanswerable: ‘what are the chances that this drug will stop me from being in a wheelchair in 10 years time… keep me fit to look after my children until they leave home…. allow me to continue in my work until retirement….?’ Undoubtedly great indirect benefits have followed

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