DIAGNOSIS CAN BE CHALLENGING, BUT IT IS CRITICAL
As it is a gradual transition, there isn't one single test or exam that can diagnose SPMS—clinical, imaging, immunologic, and pathologic criteria have yet to clearly establish when RRMS transitions to SPMS. Still, there are risk factors that may affect your patients' transition from RRMS to SPMS.1,2
All patients experience unique changes to their disease, and tracking their transition early on can potentially lead to an improved prognosis over time. Start evaluating MS progression by reviewing their history.3
Here are some of the clues that may inform a diagnosis.1,4-8
Worsening symptoms that are not correlated with relapse or changes on MRI
Difficulty with ambulation
Inability to return to baseline after relapse
Reduction in frequency of relapses over time
INVOLVE CARE PARTNERS TO HELP YOU IDENTIFY
ENGAGE WITH CARE PARTNERS
THE SUBTLE INDICATORS OF PROGRESSING MS
What's your long-term strategy to elevate care for your patients with MS? It's time to rethink how we manage MS progression over the long term.
SPMS research is ongoing. Today, new questions are being posed. Progress is being made.
MRI=magnetic resonance imaging; MS=multiple sclerosis; RRMS=relapsing-remitting MS; SPMS=secondary progressive MS.
References: 1. Lublin FD, Reingold SC, Cohen JA, et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology. 2014;83(3):278-286. 2. Tremlett H, Zhao Y, Devonshire V. Natural history of secondary-progressive multiple sclerosis. Mult Scler. 2008;14(3):314-324. 3. Scalfari A, Neuhaus A, Daumer M, Muraro PA, Ebers GC. Onset of secondary progressive phase and long-term evolution of multiple sclerosis. J Neurol Neurosurg Psychiatry. 2014;85(1):67-75. 4. 23 answers on predicting disease progression and MRI. Multiple Sclerosis International Federation website. https://www.msif.org/news/2015/12/17/23-answers-on-predicting-disease-progression-and-mri/. Updated December 30, 2015. Accessed July 9, 2018. 5. 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. 6. Ontaneda D, Fox RJ, Chataway J. Clinical trials in progressive multiple sclerosis: lessons learned and future perspectives. Lancet Neurol. 2015;14(2):208-223. 7. Fox RJ, Cohen JA. Multiple sclerosis: the importance of early recognition and treatment. Cleve Clin J Med. 2001;68(2):157-171. 8. Cognitive Changes. National Multiple Sclerosis Society website. https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Cognitive-Changes. Accessed July 12, 2018.