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Primary and secondary progressive multiple sclerosis
Sandra Vukusic1, Christian Confavreux
1European Database for Multiple Sclerosis (EDMUS) Coordinating Center and Service de Neurologie A, Hôpital Neurologique, Hospices Civils de Lyon, 59 Boulevard Pinel, Lyons Cedex 03, 69394, France. sandra.vukusic@chu-lyon.fr
Abstract:
The progressive phase of multiple sclerosis (MS) is the one most often associated with irreversible accumulation of disability. An important question remains about the place of primary progressive MS (PP-MS): does it form an integral part of the disease spectrum, or is it maybe a distinct entity? This question could apparently be very theoretical, but it is not, as patients with PP-MS remain orphans when regarding disease-modifying treatments. Thus, they are usually excluded from therapeutic trials. A clue to this question could be the comparison between the different MS subtypes with a progressive phase. We discuss here the clinical similarities and differences between secondary and primary progressive MS.
Insights
Primary progressive multiple sclerosis (PPMS) may be a distinct entity, not part of the main disease spectrum. This impacts treatment options and clinical trial eligibility for PPMS patients.
Area of Science:
- Neurology
- Immunology
- Neuroimmunology
Background:
- Multiple sclerosis (MS) is a chronic neurological disease.
- The progressive phase of MS is linked to irreversible disability.
- Primary progressive multiple sclerosis (PPMS) presents unique challenges regarding its classification and treatment.
Purpose of the Study:
- To determine if primary progressive MS (PPMS) is an integral part of the MS disease spectrum.
- To investigate the clinical similarities and differences between PPMS and secondary progressive MS (SPMS).
- To address the therapeutic orphan status of PPMS patients in clinical trials.
Main Methods:
- Comparative analysis of clinical data from patients with different MS subtypes.
- Review of existing literature on the progression and characteristics of MS phenotypes.
Main Results:
- Discussion of clinical similarities and differences between PPMS and SPMS.
- Highlighting the implications of PPMS classification on treatment accessibility.
Conclusions:
- The classification of PPMS has significant implications for patient treatment and trial inclusion.
- Further research is needed to clarify the distinct nature of PPMS within the MS spectrum.