Multiple Sclerosis Clinical Trial
Official title:
Randomized Multi-centered Study for Evaluating the Efficacy and Safety of Angioplastic Surgery of the Extracranial Veins in the Treatment of Multiple Sclerosis. Studio Randomizzato Multicentrico Per la Valutazione Dell'Efficacia e Sicurezza Dell'Intervento di Disostruzione Delle Vene Extracraniche Nel Trattamento Della Sclerosi Multipla
To assess in a double blinded randomized control trial (RCT) study design safety and
effectiveness of balloon angioplasty of the main extracranial and extravertebral veins in
multiple sclerosis (MS) associated to chronic cerebrospinal venous insufficiency (CCSVI).
Mean follow-up 1 year. 5-8 Italian centres 360 relapsing remitting (RR) MS patients will be
randomized, with expanded disability disease scale (EDSS) ranging 2-5.5, age 18-65.
Safety will be assessed by measuring serious and minor adverse effects related to treatment.
Effectiveness will be assessed by measuring 2 primary endpoints:
1. Clinical parameters will be expressed in an integrated functional measure leading to
the score, respectively, of improved, stable, worsened. Functional assessment is
performed by tools permitting a quantification and will be made by a team of
independent assessors. Clinical instrumental evaluation will be performed at baseline,
and subsequently on 3 months basis. The outcome parameters leading to the composite
functional measure are instrumental parameters, less assessor dependent, singularly
validated for measuring the disability in MS. They are the followings: A) Dynamic
Balance Assessment: Balance Master Limits of Stability (LOS). In static platform,
swinging to reach the set position of center of pressure. B) Walking Function: The
subject walks spontaneously for 10 meters with chronometric measure of time counting
the number of steps. The test calculates the walk ratio i.e. ratio between length and
step frequency. C) Manual dexterity. Box & Block test, moving wooden cubes. D)
Sphincter control: Post-voiding residual by ultrasounds. F) Visual acuity: Low-contrast
visual acuity Sloan Letter Chart.
2. Magnetic Resonance Imaging (MRI) outcome measures: T1Gad active lesion.T2 lesion volume
MRI evaluation at baseline, 6, 12 months.
Secondary endpoints are: EDSS, chronic fatigue, cognitive function, rate of restenosis,
annualized relapse rate.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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