Measuring the efficacy of treatments for multiple sclerosis (MS) is challenging, due to the heterogeneity of disease presentation and the multitude of factors influencing patient risk and prognosis. The failure of several large scale trials of putative remyelination agents has raised the question of whether the lack of success is biological or due to poor trial design. The high financial cost of clinical trials amplifies the need for more efficient trial design, reducing the size of the control group and refining the inclusion and exclusion criteria. Importantly, increasing ethnic representation would help to conduct better clinical trials, testing treatment efficacy in a sample more representative of the diversity seen in real-world populations of patients with MS.

The improvement of clinical trials in MS is crucial for accurate and efficient testing of potential therapeutics, to prevent beneficial agents slipping through the net. In this podcast, David Li-Bland, PhD, Unlearn.ai, Oakland, CA;, Gavin Giovannoni, MBBCh, PhD, FCP, FRCP, FRCPath, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK; and Mitzi Joi Williams, MD, Joi Life Wellness Group, Smyrna, GA, discuss potential improvements that can be made to clinical trials in MS.