Wednesday, 7 January 2015

Multiple Sclerosis

Evidence Based Reports

Delta-9-tetrahydrocannabinol/cannabidiol (Sativex) - for symptom improvement in adult patients with moderate to severe spasticity due to multiple sclerosis (2014)[All Wales Medicines Strategy Group] NEW

A pilot randomised controlled trial of an internet-based cognitive behavioural therapy self-management programme (MS Invigor8) for multiple sclerosis fatigue. (2013)[NHS EED]

Fampridine-SR - For the treatment of walking disability in multiple sclerosis. (2013) [MTRAC]

A systematic review of randomized, double-blind, placebo-controlled trials examining the clinical efficacy of vitamin D in multiple sclerosis. (2013) [DARE]

Cost-effectiveness of an adjustment group for people with multiple sclerosis and low mood: a randomized trial. (2013) [NHS EED]

Laquinimod for multiple sclerosis. (2013) [Cochrane Library]

Daclizumab for relapsing remitting multiple sclerosis. (2013) [Cochrane Library]

Sildenafil citrate for erectile dysfunction in patients with multiple sclerosis. (2012) [Cochrane Library]

Carnitine for fatigue in multiple sclerosis. (2012) [Cochrane Library]

Memory Rehabilitation for people with multiple sclerosis. (2012) [Cochrane Library]

Multiple Sclerosis. (2012) [Clinical Evidence] Subcription required

Laquinimod for multiple sclerosis (2012) [Cochrane Library]

Neuropsychological rehabilitation for multiple sclerosis (2011)[Cochrane Library]

Pharmacologic treatment for memory disorder in multiple sclerosis (2011)[Cochrane Library]

Natalizumab for relapsing remitting multiple sclerosis (2011)[Cochrane Library]

Multidisciplinary rehabilitation for adults with multiple sclerosis (2011)[Cochrane Library]

Hyperbaric oxygen therapy for multiple sclerosis (2011)[Cochrane Library]

Effectiveness of vocational rehabilitation intervention on the return to work and employment of persons with multiple sclerosis (2011)[Cochrane Library]

Vitamin D for the management of multiple sclerosis (2010)[Cochrane Library]

Statins for multiple sclerosis (2010)[Cochrane Library]

Glatiramer acetate for multiple sclerosis (2010)[Cochrane Library]

Carnitine for fatigue in multiple sclerosis (2010)[Cochrane Library]

Intravenous immunoglobulins for multiple sclerosis (2010)[Cochrane Library]

Therapeutic interventions in the treatment of people with multiple sclerosis with mobility problems: a literature review (2010)[DARE]

Anticholinergics for urinary symptoms in multiple sclerosis (2009)[Cochrane Library]

Oral versus Intravenous Steroids for Treatment of Relapses in Multiple Sclerosis
(2009)[Cochrane Library]

Interferon Beta for Primary Progressive Multiple Sclerosis (2009)[Cochrane Library]

Clinical Guidelines

Multiple sclerosis management of multiple sclerosis in primary and secondary care (2014)[NICE] NEW

Alemtuzumab for treating relapsing-remitting multiple sclerosis (2014)[NICE Technology Appraisals] NEW

Teriflunomide for treating relapsing–remitting multiple sclerosis (2014)[NICE Technology Appraisals] NEW

Dimethyl fumarate for treating relapsing-remitting multiple sclerosis (2014)[NICE Technology Appraisals] NEW

Recent articles in core journals

Safety and efficacy of fingolimod in patients with relapsing-remitting multiple sclerosis (FREEDOMS II): a double-blind, randomised, placebo-controlled, phase 3 trial (2014)[EvidenceUpdates] NEW

Pegylated interferon β-1a for relapsing-remitting multiple sclerosis (ADVANCE): a randomised, phase 3, double-blind study (2014)[EvidenceUpdates] NEW

Oral teriflunomide for patients with relapsing multiple sclerosis (TOWER): a randomised, double-blind, placebo-controlled, phase 3 trial (2014)[EvidenceUpdates]NEW

Effect of high-dose simvastatin on brain atrophy and disability in secondary progressive multiple sclerosis (MS-STAT): a randomised, placebo-controlled, phase 2 trial(2014)[EvidenceUpdates] NEW

Mulitiple Sclerosis and Extract of Cannabis: results of the MUSEC trial. (2013) [EvidenceUpdates]

Cell therapy for multiple sclerosis: an evolving concept with implications for other neurodegenerative diseases. (2013) [Lancet]

Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis: a systematic review to inform guideline development. (2013) [EvidenceUpdates]

Daclizumab high-yield process in relapsing-remitting multiple sclerosis (SELECT): a randomised, double-blind, placebo-controlled trial. (2013) [Lancet]

A randomized controlled trial of a cognitive rehabilitation intervention for persons with multiple sclerosis. (2013) [EvidenceUpdates]

Massage therapy and exercise therapy in patients with multiple sclerosis: a randomized controlled pilot study. (2013) [EvidenceUpdates]

Alemtuzumab versus interferon beta 1a as first-line treatment for patients with relapsing-remitting multiple sclerosis: a randomised controlled phase 3 trial. (2012) [Lancet]

Relapse and disability outcomes in patients with multiple sclerosis treated with fingolimod: subgroup analyses of the double-blind, randomised, placebo-controlled FREEDOMS study. (2012) [EvidenceUpdates]

Inflammatory cortical demyelination in early multiple sclerosis.(2011)[NEJM]

Ocrelizumab in relapsing-remitting multiple sclerosis: a phase 2, randomised, placebo-controlled, multicentre trial. (2011)[Lancet]

Randomized trial of oral teriflunomide for relapsing multiple sclerosis.(2011)[NEJM]

A phase 3 trial of extended release oral dalfampridine in multiple sclerosis. (2010)[EvidenceUpdates]

Methylprednisolone in combination with interferon beta-1a for relapsing-remitting multiple sclerosis (MECOMBIN study): a multicentre, double-blind, randomised, placebo-controlled, parallel-group trial. (2010)[EvidenceUpdates]

A phase I/II dose-escalation trial of vitamin D3 and calcium in multiple sclerosis.(2010)[EvidenceUpdates]

Daclizumab in active relapsing multiple sclerosis (CHOICE study): a phase 2, randomised, double-blind, placebo-controlled, add-on trial with interferon beta. (2010)[EvidenceUpdates]

Rituximab in patients with primary progressive multiple sclerosis: results of a randomized double-blind placebo-controlled multicenter trial. (2010)[EvidenceUpdates]

A placebo-controlled trial of oral fingolimod in relapsing multiple sclerosis. (2010)[NEJM]

Resistance training improves muscle strength and functional capacity in multiple sclerosis. (2010)[EvidenceUpdates]


Multiple Sclerosis (2014)[Mentor] updated

Brain Imaging in Multiple Sclerosis (2014)[eMedicine] updated

Multiple Sclerosis (2014)[eMedicine] updated

Multiple Sclerosis (2014)[GPnotebook] updated

Clinical Queries

Is there any evidence for the use of vitamin B12 supplements/oral or injection in the management of Multiple Sclerosis in the presence of normal vitamin B12 levels? Is there harm from over use of vitamin B12. (2011) [ATTRACT]

I have a patient who has Multiple sclerosis who is travelling to India. He will need to take chloroquine and proguanil as malaria prophylaxis. Are there any reported complications in MS with these medications? (2010)[ATTRACT]

Is there any evidence that atorvastatin alleviates symptoms, maintains remission or is useful in flare-ups of multiple sclerosis? (2009)[ATTRACT]

For women with multiple sclerosis can Depot medroxyprogesterone acetate be safely used? (2008)[Tripanswers]

Is there any evidence for the use of vitamin b12 for the treatment of fatigue in patients with multiple sclerosis? (2008)[TRIPAnswers]

What is the benefit of early diagnosis in Multiple Sclerosis; does early diagnosis and early intervention improve outcome in the longer term? (2008)[TRIPAnswers]

In a patient with multiple sclerosis, does oral treatment with a statin tablet (compared with no treatment) reduce the risk of symptoms, relapses or development of the disease? (2008)[TRIPAnswers]

Patient Information

Multiple Sclerosis. (2014) [NHS Choices] updated

Multiple Sclerosis (2014)[PatientUK] updated

Multiple sclerosis (2012)[BUPA]


1. If you are a Welsh Primary Care Professional with a clinical query send it to ATTRACT online or email us at or call 01495 332343.
2. If you would like to comment on this CME topic, or suggest a new topic for ATTRACTcme, go to the comments hyperlink below.

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