It is assumed widely that a higher relative risk reduction means greater clinical efficacy: a dangerous assumption in any field of medicine and especially so in multiple sclerosis, where the nature of the patient population has changed over time.
Relative risk reductions are often used to express differences between treatments in this and other efficacy parameters and, importantly, relative risk reductions are widely used in marketing activities by their pharmaceutical sponsors. Recent years have seen the introduction of novel, oral disease-modifying therapies (DMT) into the management of multiple sclerosis, based on the results of RCTs comparing them directly with interferon-β, the current standard of care for this condition.Ĭomparisons of annual relapse rates are key outcomes of most RCTs in this area. Appropriate interpretation of the results of these trials is essential to guide the correct application of therapies in everyday clinical practice. Randomized, controlled trials (RCTs) represent the highest level of evidence-based medicine. Direct, head-to-head comparisons are the only way to compare the efficacy of the different treatments for MS. This concept is especially important with regard to clinical trials in patients with MS, where relapse rates in placebo groups have been declining in recent decades. The use of the relative risk reduction as a measure of drug efficacy can be misleading, as it depends on the nature of the population studied: a treatment effect characterized by a lower relative risk reduction may be more clinically meaningful than one with a higher relative risk reduction.
#Cambatta smoke and mirrors dmt download trial#
Physicians often assume that a drug with a higher relative risk reduction demonstrated in one trial is more effective than a drug with a lower relative risk reduction in another, and may pass this idea on to younger physicians and to patients. A reduction in relapse rate is the main primary outcome in most clinical trials in patients with multiple sclerosis (MS), with the effect of a treatment commonly expressed as relative risk reduction for this outcome.
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