Improving Fatigue: A Goal for New MS Treatments?

“Doing the little things can make a big difference” – Yogi Berra

We constantly marvel at the hard-work, dedication and perseverance of multiple sclerosis researchers around the world.  It is through their efforts that we are constantly gaining more pieces of the MS puzzle, which in turn help us learn more and understand more about this terrible disease.  Through assembling parts of this jigsaw, we have seen an explosion of new treatment options that are providing better outcomes for people living with multiple sclerosis.  They hope, as we all do, that eventually this puzzle may be completed and that this will lead to a cure for MS in our lifetimes.

However, maybe we need to learn something from the Yogi Berra quote at the top of the page.  While the big picture of a cure is extremely necessary and important, do we sometimes need to remember that smaller advances can make a big difference?  Specifically, I want to talk about the symptom of fatigue.

In most clinical trials, the goals or endpoints are based around factors such as relapse rate, numbers of lesions, disability progression or brain atrophy.  These are chosen as the ‘gold standard’ of whether or not a new therapy is actually impacting on the disease process.

I’m sure that people living with MS want the best therapy to delay or slow any disability progression.  But what about if we have a treatment that doesn’t necessarily achieve those goals, but does make people feel much better and improves their quality of life?

Fatigue is the most common symptom that people with multiple sclerosis experience and is one that has a huge impact on their ability to stay in work and live a normal, happy life.  It really is the ‘elephant in the room’ – if we want to talk about exercise, staying in employment, cognition…all of these are hugely impacted by fatigue.  Indeed, we had comments from our community during our recent coverage of the benefits of exercise in multiple sclerosis suggesting that intense fatigue was the main barrier to using more physical therapy as part of an MS management plan.

Considering this, should we be placing a larger emphasis on any therapy that could help improve energy levels and decrease fatigue?

My thoughts are that most people with MS would answer a resounding yes!!  Do you think that a greater emphasis should be placed on improved quality of life in clinical trials?  Would you like to see effects on fatigue regarded as a critical outcome for new treatment options?  Let us know what you think!