Secondary progressive multiple sclerosis: current knowledge and future challenges

@article{Rovaris2006SecondaryPM,
  title={Secondary progressive multiple sclerosis: current knowledge and future challenges},
  author={Marco Rovaris and Christian Confavreux and Roberto Furlan and Ludwig Kappos and Giancarlo Comi and Massimo Filippi},
  journal={The Lancet Neurology},
  year={2006},
  volume={5},
  pages={343-354}
}
The secondary progressive phase of multiple sclerosis (MS), which is characterised by a steady accrual of fixed disability after an initial relapsing remitting course, is not clearly understood. Although there is no consensus on the mechanisms underlying such a transition to the progressive phase, epidemiological and neuroimaging studies indicate that it is probably driven by the high prevalence of neurodegenerative compared with inflammatory pathological changes. This notion is lent support by… 
MULTIPLE SCLEROSIS: THERAPEUTIC FRONTIERS AND PROGRESSIVE DISEASE *
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TLDR
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TLDR
The current approach to clinical trial design in progressive MS is reviewed, key ongoing challenges are outlined, and strategies to overcome such hurdles are suggested.
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TLDR
Mechanisms involved in progressive multiple sclerosis, correlations between histopathology and magnetic resonance imaging studies, along with possible new therapeutic approaches are discussed.
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TLDR
The need to establish criteria for the diagnosis of SPMS is currently of crucial importance due to emerging treatment opportunities including siponimod, a sphingosine 1-phosphate (S1P) receptor modulator selective for S1P1 and S 1P5 receptors.
The natural history of secondary progressive multiple sclerosis
TLDR
Three factors influencing the onset of SPMS in untreated patients with RRMS in British Columbia were identified: motor onset symptoms and male gender were associated with both a shorter time to and a younger age at SPMS, while a newer age at disease onset should not be viewed as indicating a better prognosis.
Natural history comparisons of primary and secondary progressive multiple sclerosis reveals differences and similarities
TLDR
Although there were some similarities between SPMS and PPMS, the former had a later onset age in the British Columbian MS cohort, such that the baseline characteristics, including age at progression, may shift.
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