Secondary Progressive Multiple Sclerosis
Tjalf Ziemssen, Virender Bhan, Jeremy Chataway, Tanuja Chitnis, Bruce Cree, Eva Havrdová, Ludwig Kappos, Pierre Labauge, Aaron Miller, Jin Nakahara, Celia Oreja‐Guevara, Jacqueline Palace, B. Singer, María Trojano, Ashwini Patil, Benedict Rauser, Thomas Hach
Abstract
Many challenges exist in the precise diagnosis and clinical management of secondary progressive multiple sclerosis (SPMS) because of the lack of definitive clinical, imaging, immunologic, or pathologic criteria that demarcate the transition from relapsing-remitting MS to SPMS. This review provides an overview of the diagnostic criteria/definition and the heterogeneity associated with different SPMS patient populations; it also emphasizes the importance of available prospective/retrospective tools to identify patients with SPMS earlier in the disease course so that approved disease-modifying therapies and nonpharmacological strategies will translate into better outcomes. Delivery of such interventions necessitates an evolving patient-clinician dialog within the context of a multidisciplinary team.