Clinical Trial Design and Personalized Medicine in Multiple Sclerosis

Opinion
Video

Ahmed Obeidat, MD, PhD, Riley Bove, MD, Stephen Krieger, MD, and Erin Longbrake, MD, PhD, consider how clinical trials can be enhanced to account for diverse patient populations.

This is a video synopsis/summary of a panel discussion involving Ahmed Obeidat, MD, PhD; Riley Bove, MD; Stephen Krieger, MD; and Erin Longbrake, MD, PhD.

The conversation revolves around the challenges and potential solutions for implementing personalized medicine in multiple sclerosis (MS) clinical trials. Despite the importance of personalized treatment approaches, current trials typically employ a 1-size-fits-all methodology, lacking personalized recruitment or randomization.

Various biomarkers, including imaging and fluid biomarkers like neurofilament light chain (NFL) and glial fibrillary acidic protein (GFAP), are discussed as potential tools for personalized medicine. However, their integration into clinical trial design remains limited. The need for better incorporation of biomarkers and other factors to enable personalized trial recruitment and treatment selection is emphasized.

The metaphor of clinical trials as blending different fruits into a smoothie is used to illustrate the challenge of treating patients with diverse characteristics using uniform approaches. The conversation highlights the importance of recruiting a diverse range of patients in clinical trials to better reflect the heterogeneity of the disease and patient population.

Efforts to increase trial diversity and accessibility, such as specific trials for underrepresented populations and pragmatic trial designs, are discussed. Examples like the CHIMES study, which focused on minority groups, demonstrate the importance of considering socioeconomic factors and compensating participants for the costs associated with trial participation.

The conversation underscores the need for a shift towards more flexible and adaptive trial designs, drawing lessons from oncology literature and pragmatic trial approaches. By incorporating these strategies, clinical trials can become more inclusive, relevant, and effective in advancing personalized medicine for MS.

Video synopsis is AI-generated and reviewed by NeurologyLive editorial staff.

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