The steady flow of potential new treatments for multiple sclerosis continues with data resulting from studies ranging in complexity from early pilot trials to phase three studies. While this is in itself encouraging, interpretation of the data presented, and in particular evaluation of the potential clinical usefulness of an agent, is often less than straightforward. Improved understanding of the immunopathogenesis of multiple sclerosis and better trial design incorporation more appropriate and responsive outcome measures should be grounds for continuing therapeutic optimism.