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2007: May Susanne; Gilman Sid; Sowell B Brooke; Thomas Ronald G; Stern Matthew B; Colcher Amy; Tanner Caroline M; Huang Neng; Novak Peter; Reich Stephen G; Jankovic Joseph; Ondo William G; Low Phillip A; Sandroni Paola; Lipp Axel; Marshall Frederick J; Wooten Frederick; Shults Clifford W;
Potential outcome measures and trial design issues for multiple system atrophy.
Movement disorders : official journal of the Movement Disorder Society 2007;22(16):2371-7.
Multiple system atrophy (MSA) is a neurodegenerative disorder exhibiting a combination of parkinsonism, cerebellar ataxia, and autonomic failure. A disease-specific scale, the Unified Multiple System Atrophy Rating Scale (UMSARS), has been developed and validated to measure progression of MSA, but its use as an outcome measure for therapeutic trials has not been evaluated. On the basis of twelve months of follow-up from an observational study of 67 patients with probable MSA, we evaluated three disease-specific scores: Activities of Daily Living, Motor Examination, and a combined score from the UMSARS and two general health scores, the Physical Health and Mental Health scores of the SF-36 health survey, for their use as outcome measures in a therapeutic trial. We discuss related design issues and provide sample size estimates. Scores based on the disease-specific UMSARS seemed to be equal or superior to scores based on the SF-36 health survey. They appeared to capture disease progression, were well correlated and required the smallest sample size. The UMSARS Motor Examination score exhibited the most favorable characteristics as an outcome measure for a therapeutic trial in MSA with 1 year of follow-up.

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