The Patient-Centered Outcomes Research Institute has awarded $38 million in grants for five projects that compare the effectiveness of different multiple sclerosis treatment strategies.

A key aim of the research is to improve knowledge about the therapies to help doctors and patients choose the healthcare option that best meets patients’ needs. The projects will address MS community priorities, the institute said.

The Washington-based non-profit organization’s mission is to fund research that helps patients and care-givers make better-informed decisions about the healthcare choices they face every day.

“These large-scale research awards should have powerful impact for people with MS by answering critical real-world questions about treatment strategies and their effectiveness,” Bruce Bebo, executive vice president of research at the National MS Society, said in a news release.

Johns Hopkins University researchers will conduct one of the projects. Ellen M. Mowry and Scott Newsome will look at whether the use of stronger drugs in the early stages of MS can prevent or delay the progression of the disease, compared with standard approaches.

The $13.5 million study will involve about 900 patients with newly diagnosed relapsing or remitting MS. Participants will be randomly assigned to a standard treatment escalation strategy or to a more aggressive approach that could increase the risk of side effects.

A $10.6 million Cleveland Clinic study will also compare the standard escalation strategy with a more aggressive approach. Daniel Ontaneda and Nikolaos Evangelou will lead the study, which will use MRI brain scans and patient-reported outcomes to evaluate different treatment strategies. The scans will look at brain volume.

Scott Newsome and Robert Motl of the Shepherd Center in Atlanta will lead a $5.7 million project that focuses on exercise as an MS therapy. It will compare the effectiveness of exercise programs at gyms or rehabilitation facilities with a tele-rehabilitation program delivered to a patient’s home electronically. The team will assess patients’ ability to walk and their self-reports on mobility, symptoms, and quality of life.

A $4.9 million project at Case Western Reserve University in Cleveland will compare the effectiveness of three fatigue-management programs. One program will be delivered at a treatment facility. Patients will receive the others electronically at home.

The fifth study, at the University of Michigan, will also deal with fatigue treatment. It will look at whether cognitive behavioral therapy or the commonly used medication Provigil (modafinil) does a better job of addressing fatigue. It will also assess a combination of both fatigue management therapies in MS patients. Tiffany Braley and Anna Kratz will lead the $3.5 million study.

“This research will help patients and clinicians address some of the difficult questions that arise with a disease that has a wide variety of symptoms, such as fatigue, pain, loss of vision and loss of coordination,” said Joe Selby, the institute’s executive director.