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Biomedical subjects

R B Loewenson

Publications and source records attributed to R B Loewenson.

At least 37 records · Page 2Linked to original sources

The design of clinical studies to assess therapeutic efficacy in multiple sclerosis.

Poorly designed trials of therapy for multiple sclerosis (MS) can waste time and money, and may lead either to false hopes or to the overlooking of a potentially effective treatment. A well-designed trial may well develop useful scientific information even if the putative therapy fails to show any therapeutic effect. The diagnosis, clinical course, and definitions of the stages of MS are discussed as they relate to trials of therapy. The goals of such trials include favorable modification of an exacerbation, favorable modification or prevention of future exacerbations, effective treatment of the progressive stage, and improvement of function in the stable-deficit stage. There should be an orderly progression from a small preliminary trial to a modest pilot trial and, when indicated, a full trial. All types of trials require careful organization and management, appropriate selection of patients, and properly planned and recorded observations. The treatment contrast--how the new treatment will be evaluated--provides the essential structure of the trial. The hypothesis being examined, the treatment contrast, and the observations being made in the designed clinical trial will govern the form of the analysis and the nature of the interpretations. Each goal requires that specific strategies and design considerations be applied to preliminary, pilot, and full trials.

Clinical Trials as Topic↗

Essential tremor: treatment with propranolol.

A double-blind trial of propranolol, in a dosage of 120 mg a day, and placebo was conducted in 11 patients with essential tremor. An improvement in tremor was observed in all patients who received propranolol and was most pronounced in the upper extremities. The favorable clinical assessment was further confirmed by improvement in a grooved pegboard test and in the quality of handwriting as evaluated by two "blind" observers. No side effects were encountered. It is concluded that propranolol is at present the best available drug for the treatment of essential tremor.

Adult↗