Multiple Sclerosis, Relapsing-Remitting Clinical Trial
Official title:
A Phase IV, Observational, Open-label, Multi-center Comparison Study of the Newly Developed and Validated MusiQoL (Multiple Sclerosis International Quality of Life Questionnaire) Instrument With the Health-related QoL (MSQOL-54) Questionnaire in Subjects With Relapsing Forms of Multiple Sclerosis (RMS*) on Rebif® Therapy
Significant data from placebo-controlled clinical trials have demonstrated the efficacy of
Rebif in relapsing remitting multiple sclerosis (RRMS) with reduction in relapse rate, delay
in disability progression, and reduction in magnetic resonance imaging (MRI) activity and
accumulation of lesion burden. Multiple sclerosis (MS), a chronic neurological diseases, can
have diverse effects on the lives of subjects and their families. In controlled clinical
trials, clinical measurement in MS has focused on impairments of neurological assessment
using Expanded Disability Status Score (EDSS). The assessment of the impact of MS on the
non-physical aspect of dysfunction is not often measured, or reported. Furthermore,
traditional clinical measures have not been able to assess the effects of neurological
illness on quality of life (QoL), which is becoming an increasingly important topic to
neurologists treating subjects with varied neurological conditions.
This observational, one arm, multicentric study is aimed to assess the usefulness of the
Multiple Sclerosis International Quality of Life Questionnaire (MusiQoL) instrument in
comparison with the Multiple Sclerosis Quality of Life-54 instrument (MSQOL-54
questionnaire) in RMS subjects on Rebif therapy and to assess the effectiveness of Rebif
therapy using health related quality of life (HRQoL) measures.
Multiple sclerosis is a chronic, inflammatory, demyelinating disease of the central nervous
system (CNS) and is one of the most common causes of neurological disability in young
adults. The neuropathology of the disease is marked by accumulation of leukocytes in the
CNS, oligodendrocyte loss, demyelination, axonal atrophy, and neuronal loss. Clinically it
is characterized by multi-focal recurrent attacks of neurological symptoms and signs with
variable recovery and eventually, the majority of subjects develop a progressive clinical
course of MS. The exact cause of MS is unknown, although an autoimmune process has been
implicated. Genetic susceptibility plays a role in disease initiation but unidentified
environmental factors may also be involved. Three clinical forms of MS are recognized:
primary progressive multiple sclerosis (PPMS), secondary progressive multiple sclerosis
(SPMS) and RRMS. Primary progressive subjects are characterized by slow and steady
accumulation of neurological deficits from onset without superimposed attacks. Subjects with
RRMS have exacerbations or relapses with subsequent variable recovery (remission). Secondary
progressive multiple sclerosis is characterized by the steady accumulation of significant
and persistent neurological deficit with or without superimposed relapses.
The concept of quality of life (QoL) is defined by the World Health Organization (WHO) as an
individual's perception of his or her life within the cultural context and value system in
which he or she lives, in respect to objectives, expectations, norms and worries. It is a
very complex and broad concept, influenced at various levels by the subject's physical
health state, psychological health state, level of independence, social relations and
relationship with the overall surrounding environment. A critical element of HRQoL is that
it reflects the subject's assessment of the impact of his/her illness, not the physician's
perspective. Professional interest in the concept of QoL has increased over the course of
the past years, particularly within the framework of health care programs for chronic
diseases. Health related quality of life measures can be subdivided into generic and
disease-specific measures. Generic measures are designed to assess subjects with diverse
medical conditions and they may not capture all relevant aspects of a specific illness.
However, disease-specific measures developed from generic HRQoL tools may not truly reflect
perspectives from the subjects with specific diseases. The MusiQoL questionnaire is a
subject focused questionnaire being developed by an independent scientific steering
committee in conjunction with MS subjects, neurologists, and health economists since 2000.
OBJECTIVES
- To assess the usefulness of MusiQoL in clinical practice in comparison with the
established disease specific QoL instrument MSQOL-54
- To evaluate the effectiveness of Rebif therapy with respect to HRQoL in a longitudinal
study in subjects with RMS
This is an observational, one arm, multicentric study. Quality of life data from the MusiQoL
instrument and MSQOL-54 questionnaire, as well as physical health outcomes such EDSS, will
be collected bi-annually in subjects with RMS.
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Observational Model: Cohort, Time Perspective: Prospective
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