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The effectiveness of multiple sclerosis drugs is often judged by how much they reduce the frequency of relapses, which are severe flare-ups of symptoms, compared to a placebo in clinical trials.
Despite these improvements, however, the vast majority of patients continue to suffer relapses, which suggests a prominent role for either primary, innate drug resistance, or secondary, acquired drug resistance.
One study which was concerned with the prediction of relapses and also took into consideration stable patients, used a more comprehensive definition of relapses which, in addition to referrals to an inpatients department of a hospital, also included attempted suicides [34].
After the relapses, which happened at different times, Chris had acquired an impressive two years of sobriety and Dave five long and hard-fought months.
The disease course of relapsing remitting (RRMS) involves periods of clinical remission interspersed by exacerbations or relapses, which vary in their severity and duration.
However, some patients do have late relapses, which are usually chemotherapy-resistant, or refractory diseases following their first-line chemotherapy.
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After a grand finale of a relapse which left me more dead than alive, I contacted an ibogaine treatment provider who I had traced through the internet.
But Kuyken acknowledges the tough financial climate means mental health trusts often can't make MBCT a priority: "Their core business is treatment of serious illness rather than prevention of relapse, which can mean that therapies like MBCT get sidelined".
Curbishley maintains that there is money to spend but he has had to put a brave face on set-backs, including the midfielder Kieron Dyer's injury relapse, which will sideline him until October at the earliest, and Robert Green's public show of dissatisfaction with the financial state of affairs.
The bawdier second act reworks Vanbrugh's "Relapse," which was written as a takedown sequel to Cibber's play, picking up with the same characters just as Loveless begins to find monogamy constricting.
Five years on, and he's taken several steps backward with Relapse, which might be more aptly titled Rehash, so uninspiredly does it reprise the bonehead horror-comic fantasies of his debut.
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