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Updated: Nov 3, 2025

Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
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Secondary Progressive Multiple Sclerosis: New Insights.

Bruce A C Cree1, Douglas L Arnold2, Jeremy Chataway2

  • 1From the UCSF Weill Institute for Neurosciences, Department of Neurology (B.A.C.C.), University of California San Francisco; NeuroRx Research (D.L.A.), Montreal; Brain Imaging Centre (D.L.A.), Montreal Neurological Institute, McGill University, Canada; Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation (J.C.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London; National Institute for Health Research (J.C.), University College London Hospitals, Biomedical Research Centre, UK; Brigham Multiple Sclerosis Center (T.C.), Brigham and Women's Hospital, Boston, MA; Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute (R.J.F.), Cleveland Clinic, OH; Oxford PharmaGenesis (A.P.R.), UK; Novartis Pharma AG (N.M.), Basel, Switzerland; and Center for Brain Research (H.L.), Medical University of Vienna, Austria. bruce.cree@ucsf.edu.

Neurology
|June 5, 2021
PubMed
Summary
This summary is machine-generated.

Multiple sclerosis (MS) often progresses from relapsing-remitting MS (RRMS) to secondary progressive MS (SPMS). Early identification and treatment of SPMS are crucial for better patient outcomes.

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Area of Science:

  • Neurology
  • Immunology
  • Clinical Medicine

Background:

  • Multiple sclerosis (MS) commonly transitions from a relapsing-remitting course (RRMS) to secondary progressive MS (SPMS).
  • SPMS is characterized by insidious disability worsening independent of clinical relapses.
  • Significant differences exist in therapeutic responses between RRMS and SPMS.

Purpose of the Study:

  • To review the pathology, differentiation, diagnosis, and treatment of SPMS.
  • To highlight the importance of identifying the transition from RRMS to SPMS.
  • To discuss the challenges in treating SPMS, particularly the lack of effective treatments until recently.

Main Methods:

  • Literature review focusing on the clinical, imaging, immunologic, and pathological aspects of MS progression.
  • Analysis of the diagnostic criteria and therapeutic challenges in differentiating and managing SPMS.
  • Emphasis on the critical transition points in the disease course.

Main Results:

  • Clear diagnostic criteria for the RRMS to SPMS transition are currently lacking.
  • Historically, treatments effective in RRMS showed limited efficacy in SPMS.
  • The conversion to SPMS signifies irreversible disability progression.

Conclusions:

  • Early and accurate identification of SPMS is essential for effective management.
  • Development of specific diagnostic tools is needed to mark the transition from RRMS to SPMS.
  • Improved long-term outcomes for SPMS patients depend on early identification and appropriate therapies.