YOUR PATIENT MAY BE HEADED TOWARD SPMS
The transition from RRMS to SPMS may be difficult to detect right away due to the subtle nature of progressing MS. Although SPMS is frequently diagnosed retrospectively, there are several risk factors that may affect progression. The identification of these risk factors might help with earlier diagnosis.1-3
Many RRMS patients may not initially experience severe functional deterioration, but their disability will inevitably continue to worsen over time.4
Recognizing new or subtle changes in symptoms is vital to evaluating MS progression.
CONSIDER HOW PROGRESSION COULD IMPACT YOUR PATIENTS
Patients with SPMS can experience a wide spectrum of symptoms, such as varying rates of disability, with or without the persistence of relapses.5
While some may perceive patients with SPMS to be wheelchair bound or to have higher EDSS scores, a clinical study demonstrated that many patients can maintain an EDSS score of 6 or below for over 8 years.3
The transition to SPMS will become more evident over time, though every patient will experience a range of symptoms related to his or her disability.5
DISABILITY CHANGES OVER TIME1,4,6,7
The EDSS score and factors of progression displayed here are examples of a hypothetical patient's progression. This set of examples is not intended to be used as a diagnostic tool for SPMS.
Earlier recognition and timely intervention may help to delay disability progression and preserve functionality.8
YOUR PATIENTS WANT TO KNOW THEIR PROGNOSIS
Develop an open dialogue about progressing MS with your patients, so that they can become more aware of their MS progression and share important information with you sooner.
*An online survey of 3175 patients with MS about prognosis communication experiences, attitudes, and preferences.
EDSS=Expanded Disability Status Scale; MS=multiple sclerosis; RRMS=relapsing-remitting MS; SPMS=secondary progressive MS.
References: 1. Katz Sand I, Krieger S, Farrell C, Miller AE. Diagnostic uncertainty during the transition to secondary progressive multiple sclerosis. Mult Scler. 2014;20(12):1654-1657. 2. Lublin FD, Reingold SC, Cohen JA, et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology. 2014;83(3):278-286. 3. Tremlett H, Zhao Y, Devonshire V. Natural history of secondary-progressive multiple sclerosis. Mult Scler. 2008;14(3):314-324. 4. Fox RJ, Cohen JA. Multiple sclerosis: the importance of early recognition and treatment. Cleve Clin J Med. 2001;68(2):157-171. 5. Secondary progressive MS. National Multiple Sclerosis Society website. https://www.nationalmssociety.org/What-is-MS/Types-of-MS/Secondary-progressive-MS. Accessed July 10, 2018. 6. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS). Neurology. 1983;33(11):1444-1452. 7. Bsteh G, Ehling R, Lutterotti A, et al. Long term clinical prognostic factors in relapsing-remitting multiple sclerosis: insights from a 10-year observational study. PLoS ONE. 2016;11(7): e0158978. doi:10.1371/journal.pone.0158978. 8. Gross HJ, Watson C. Characteristics, burden of illness, and physical functioning of patients with relapsing-remitting and secondary progressive multiple sclerosis: a cross-sectional US survey. Neuropsychiatr Dis Treat. 2017;13:1349-1357. 9. Dennison L, Brown M, Kirby S, Galea I. Do people with multiple sclerosis want to know their prognosis? A UK nationwide study. PLoS One. 2018;13(2):e0193407. doi:10.1371/journal.pone.0193407.