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Secondary Progressive Multiple Sclerosis: New Insights
In most cases, multiple sclerosis (MS) begins with a relapsing-remitting course followed by insidious disability worsening that is independent from clinically apparent relapses and is termed secondary progressive MS (SMPS). Major differences exist between relapsing-remitting MS (RRMS) and SPMS, espe...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397587/ https://www.ncbi.nlm.nih.gov/pubmed/34088878 http://dx.doi.org/10.1212/WNL.0000000000012323 |
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author | Cree, Bruce A.C. Arnold, Douglas L. Chataway, Jeremy Chitnis, Tanuja Fox, Robert J. Pozo Ramajo, Angela Murphy, Niamh Lassmann, Hans |
author_facet | Cree, Bruce A.C. Arnold, Douglas L. Chataway, Jeremy Chitnis, Tanuja Fox, Robert J. Pozo Ramajo, Angela Murphy, Niamh Lassmann, Hans |
author_sort | Cree, Bruce A.C. |
collection | PubMed |
description | In most cases, multiple sclerosis (MS) begins with a relapsing-remitting course followed by insidious disability worsening that is independent from clinically apparent relapses and is termed secondary progressive MS (SMPS). Major differences exist between relapsing-remitting MS (RRMS) and SPMS, especially regarding therapeutic response to treatment. This review provides an overview of the pathology, differentiation, and challenges in the diagnosis and treatment of SPMS. We emphasize the criticality of conversion from a relapsing-remitting to a secondary progressive disease course not only because such conversion is evidence of disability progression, but also because, until recently, treatments that effectively reduced disability progression in relapsing MS were not proven to be effective in SPMS. Clear clinical, imaging, immunologic, or pathologic criteria marking the transition from RRMS to SPMS have not yet been established. Early identification of SPMS will require tools that, together with the use of appropriate treatments, may result in better long-term outcomes for the population of patients with SPMS. |
format | Online Article Text |
id | pubmed-8397587 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-83975872021-08-31 Secondary Progressive Multiple Sclerosis: New Insights Cree, Bruce A.C. Arnold, Douglas L. Chataway, Jeremy Chitnis, Tanuja Fox, Robert J. Pozo Ramajo, Angela Murphy, Niamh Lassmann, Hans Neurology Review In most cases, multiple sclerosis (MS) begins with a relapsing-remitting course followed by insidious disability worsening that is independent from clinically apparent relapses and is termed secondary progressive MS (SMPS). Major differences exist between relapsing-remitting MS (RRMS) and SPMS, especially regarding therapeutic response to treatment. This review provides an overview of the pathology, differentiation, and challenges in the diagnosis and treatment of SPMS. We emphasize the criticality of conversion from a relapsing-remitting to a secondary progressive disease course not only because such conversion is evidence of disability progression, but also because, until recently, treatments that effectively reduced disability progression in relapsing MS were not proven to be effective in SPMS. Clear clinical, imaging, immunologic, or pathologic criteria marking the transition from RRMS to SPMS have not yet been established. Early identification of SPMS will require tools that, together with the use of appropriate treatments, may result in better long-term outcomes for the population of patients with SPMS. Lippincott Williams & Wilkins 2021-08-24 /pmc/articles/PMC8397587/ /pubmed/34088878 http://dx.doi.org/10.1212/WNL.0000000000012323 Text en Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Review Cree, Bruce A.C. Arnold, Douglas L. Chataway, Jeremy Chitnis, Tanuja Fox, Robert J. Pozo Ramajo, Angela Murphy, Niamh Lassmann, Hans Secondary Progressive Multiple Sclerosis: New Insights |
title | Secondary Progressive Multiple Sclerosis: New Insights |
title_full | Secondary Progressive Multiple Sclerosis: New Insights |
title_fullStr | Secondary Progressive Multiple Sclerosis: New Insights |
title_full_unstemmed | Secondary Progressive Multiple Sclerosis: New Insights |
title_short | Secondary Progressive Multiple Sclerosis: New Insights |
title_sort | secondary progressive multiple sclerosis: new insights |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397587/ https://www.ncbi.nlm.nih.gov/pubmed/34088878 http://dx.doi.org/10.1212/WNL.0000000000012323 |
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