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Identification and diagnosis of Secondary Progressive Multiple Sclerosis during the clinical encounter: Results from
E Alvarez1, K V Nair1, M Gorritz2
1Rocky Mountain Multiple Sclerosis Center at the University of Colorado, Aurora, CO, USA.
Background:
It is difficult to characterize the transition from relapsing-remitting multiple sclerosis (RRMS) to secondary progressive MS (SPMS), due to symptomatic variability across patients. Diagnosis of SPMS is prolonged and often established retrospectively, as it is based on patient clinical history and symptoms. This cross-sectional study aimed to identify MS neurologist reported clinical indicators deemed important in diagnosing SPMS in clinical practice.
Methods:
A web-based quantitative survey was conducted among MS-treating neurologists across the United States in January 2019. The questionnaire comprised of 17 questions evaluating primary clinical indicators used by neurologists in assessing patient progression to SPMS. Treatment approach and factors influencing treatment decision-making following SPMS diagnosis were also analyzed in the survey.
Results:
Overall, 300 neurologists completed the survey; most of the respondents were general MS-treating neurologists (63%) and from private care setting (58%). The overall respondents as well as MS-focused neurologists ranked patient history (45% and 42%, respectively) and patients' neurological exam (39% and 44%, respectively) as -primary clinical indicators of SPMS diagnosis. 57% of neurologists always or mostly switched disease modifying therapies after progression to SPMS, and mostly considered 3-6 months' assessment interval to diagnose SPMS.
Conclusion:
The survey indicated that neurologists are able to recognize signs of SPMS within six months of symptomatic assessment. The diagnosis is primarily based on patient history among MS-treating neurologists. Therefore, continued education to neurologists may facilitate early diagnosis and timely introduction of effective treatment to manage the progression of SPMS.
Insights
Diagnosing secondary progressive multiple sclerosis (SPMS) relies on patient history and neurological exams. Early recognition by neurologists aids timely treatment for SPMS progression.
Area of Science:
- Neurology
- Clinical Practice
- Multiple Sclerosis Research
Background:
- Transitioning from relapsing-remitting multiple sclerosis (RRMS) to secondary progressive multiple sclerosis (SPMS) is challenging due to varied symptoms.
- SPMS diagnosis is often delayed and retrospective, relying on clinical history and symptom evaluation.
- Identifying key clinical indicators used by neurologists for SPMS diagnosis is crucial for timely intervention.
Purpose of the Study:
- To identify clinical indicators MS neurologists consider important for diagnosing SPMS.
- To analyze treatment decisions and influencing factors post-SPMS diagnosis.
Main Methods:
- A quantitative web-based survey was distributed to 300 US-based MS-treating neurologists in January 2019.
- The survey assessed 17 questions on primary clinical indicators for SPMS diagnosis.
- It also evaluated treatment approaches and decision-making factors after SPMS diagnosis.
Main Results:
- Patient history (45%) and neurological exam (39%) were primary indicators for SPMS diagnosis among all respondents.
- MS-focused neurologists also prioritized patient history (42%) and neurological exam (44%).
- 57% of neurologists switched disease-modifying therapies post-SPMS diagnosis, with a 3-6 month assessment interval commonly used.
Conclusions:
- Neurologists can identify SPMS signs within a six-month assessment period.
- Patient history is the predominant factor in SPMS diagnosis by neurologists.
- Enhanced education for neurologists can promote earlier SPMS diagnosis and treatment initiation.
