Glossary beginning with R

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Randomisation

Randomisation is a part of the clinical trial process where participants are allocated at random to the treatment groups, usually using a computer programme. This is done so that each group has a random mix of people of different ages, sex and state of health. This ensures that if one group improves after treatment it is due to the therapy provided and not other factors.

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Rehabilitation

Rehabilitation can combine many different approaches to managing MS – physiotherapy, occupational therapy, dietary advice, employment services, support for care at home, and so on. Whatever services are involved, the aim is to lessen the impact of MS on someone’s life.

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Relapse

A relapse or flare-up of symptoms (also known as an attack or exacerbation) is defined by the appearance of new symptoms, or the return of old symptoms, for a period of 24 hours or more – in the absence of a change in core body temperature or infection. Relapses occur when inflammatory cells attack the myelin of specific nerve fibres, interfering with the job the nerve normally does. For example, inflammation in the optic nerve may result in visual problems. Relapses usually take a few days to develop and can last for days, weeks (most commonly) or months, varying from mild to severe. Relapses occur when inflammatory cells attack the myelin of specific nerve fibres, interfering with the job the nerve normally does. For example, inflammation in the optic nerve may result in visual problems. Relapses usually take a few days to develop and can last for days, weeks (most commonly) or months, varying from mild to severe.

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Relapsing remitting MS

In relapsing remitting MS, people have relapses or attacks of symptoms that occur for a period of time – days, weeks or months – and then improve, either partially or completely. Around 85 per cent of people with MS are diagnosed with this type.

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Remission

In relapsing remitting MS, people have distinct relapses - or attacks - of symptoms, followed by periods of remission. During remission, symptoms improve or go away entirely. Periods of remission can last for weeks, months or even years.

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Remyelination

Remyelination, or myelin repair, is the replacement of lost or damaged myelin surrounding nerve fibres. When myelin becomes damaged or lost, this exposes the nerve fibres themselves to damage or loss, which can lead to permanent disability. As there are currently no treatments that can repair damaged myelin, this is a major focus of MS research.

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Risk-sharing scheme

The Risk Sharing Scheme was set up by the Department of Health in 2001 as a way of making MS disease modifying treatments glatiramer acetate and interferon betas available following a judgement by NICE that they were not cost effective. The cost of the drugs is shared by the Department of Health and the manufacturers of the drugs. If the drugs fail to be as effective as promised during the scheme, the manufacturers will subsidise the cost by reducing prices. The scheme applies throughout the UK and is due to run until 2015.

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Rituximab

Rituximab is a potential treatment for MS. It is a monoclonal antibody that has been used to treat certain types of blood cancer. It targets certain cells of the immune system that may be involved in inflammation and has been trialled in people with MS.

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