Evidence map›Paper›PMID 42763308›Full record

ArticleJournal of neurology2026

Clinical trials in non-ambulatory people with progressive multiple sclerosis: can the nine hole peg test step up as primary outcome measure?

Miguel D'Haeseleer, Eva M M Strijbis, Gary Cutter, Laetitia Della Faille, Marie B D'hooghe, Daphne Kos, Anne-Lotte Lison, Jop Mostert, Guy Nagels, Pavle Repovic and 4 more

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Article in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Miguel D'HaeseleerNational Multiple Sclerosis Center, Vanheylenstraat 16, 1820, Melsbroek, Belgium. miguel.dhaeseleer@mscenter.be.ORCID http://orcid.org/0000-0003-4378-0089
Eva M M StrijbisDepartment of Neurology, MS Center Amsterdam, Vrije Universiteit Medisch Centrum, Amsterdam, The Netherlands.
Gary CutterDepartment of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA.
Laetitia Della FailleNational Multiple Sclerosis Center, Vanheylenstraat 16, 1820, Melsbroek, Belgium.
Marie B D'hoogheNational Multiple Sclerosis Center, Vanheylenstraat 16, 1820, Melsbroek, Belgium.
Daphne KosNational Multiple Sclerosis Center, Vanheylenstraat 16, 1820, Melsbroek, Belgium.
Anne-Lotte LisonNational Multiple Sclerosis Center, Vanheylenstraat 16, 1820, Melsbroek, Belgium.
Jop MostertDepartment of Neurology, Rijnstate Hospital, Arnhem, The Netherlands.
Guy NagelsDepartment of Neurology, University Hospital Brussels, Brussels, Belgium.
Pavle RepovicMultiple Sclerosis Center, Swedish Neuroscience Institute, Seattle, WA, USA.
Bernard M J UitdehaagDepartment of Neurology, MS Center Amsterdam, Vrije Universiteit Medisch Centrum, Amsterdam, The Netherlands.
Ann Van RemoortelNational Multiple Sclerosis Center, Vanheylenstraat 16, 1820, Melsbroek, Belgium.
Jeroen Van SchependomNEUR Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium.
Marcus W KochNational Multiple Sclerosis Center, Vanheylenstraat 16, 1820, Melsbroek, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNon-ambulatory patients are generally excluded from clinical trials in progressive multiple sclerosis (MS), even though they continue to experience disability worsening. Using hand function - assessed with the Nine Hole Peg Test (NHPT) - as a primary endpoint could enable their inclusion. We aimed to describe two-year NHPT trajectories and identify predictors of worsening in this population to inform the design of such trials.

methodsWe included 131 patients from the Belgian National MS Center (Melsbroek) database with (1) progressive MS, (2) a baseline Expanded Disability Status Scale (EDSS) score of ≥ 7.0, and (3) available NHPT and EDSS scores at baseline, 12, and 24 months. We applied four definitions for NHPT worsening: classical (C), best hand (BH), worst hand (WH), and either hand (EH). We investigated associations between baseline characteristics and NHPT worsening with logistic regression.

resultsAcross all four definitions, NHPT performance consistently worsened over time. C, BH, and WH outcomes showed similar progression rates: approximately 25% at 12 months and 40% at 24 months. The EH-NHPT definition proved most sensitive (35.9% worsening at 12 months and 52.7% at 24 months), with paradoxical improvement observed in 15.3% and 9.2% of patients, respectively. Older age and poor hand function at baseline modestly decreased the likelihood of EH-NHPT worsening at 24 months; there were no significant predictors at 12 months.

conclusionHand function deteriorates in non-ambulatory people with progressive MS. The EH-NHPT may represent a sensitive and feasible endpoint for future clinical trials in this often-neglected population.

Indexed as

Clinical Trials as TopicHandMultiple Sclerosis, Chronic ProgressiveOutcome Assessment, Health CareAdultDisability EvaluationDisease ProgressionFemaleHumansMaleMiddle AgedHand functionMultiple sclerosisNine Hole Peg TestNon-ambulatoryProgressive disease

Identifiers

PMID42763308

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.