Challenges and opportunities in designing clinical trials for neuromyelitis optica.

For example, in the recent open-label study of eculizumab, 2 on-study events (back pain alone in one subject and a one-line change of visual acuity in a second) were of equivocal significance. 21 Although experience with stratification of attack severity is limited, a simple system for rating optic nerve and spinal cord attacks has been applied to retrospective studies. 12 This strategy is similar to well-accepted clinical scales used in MS 46 and focuses on visual, pyramidal, sensory, and sphincter functions that are most consistently affected in NMO.

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