Identifying Progression in Multiple Sclerosis: New Perspectives

Abstract

The identification of progression in multiple sclerosis is typically retrospective. Given the profound burden of progressive multiple sclerosis, and the recent development of effective treatments for these patients, there is a need to establish measures capable of identifying progressive multiple sclerosis early in the disease course. Starting from recent pathological findings, this review assesses the state of the art of potential measures able to predict progressive multiple sclerosis. Future promising biomarkers that might shed light on mechanisms of progression are also discussed. Finally, expansion of the concept of progressive multiple sclerosis, by including an assessment of cognition, patient‐reported outcomes, and comorbidities, is considered. ANN NEUROL 2020;88:438–452

Krankheitsmodifizierende Therapie der sekundär progredienten Multiplen Sklerose

“…An der Etablierung von Biomarkern für den Übergang in die sekundäre Progredienz wird intensiv gearbeitet [18]. Die schleichende Krankheitsprogression ist im konventionellen MRT derzeit schwer darstellbar [2].…”

Should We Use Clinical Tools to Identify Disease Progression?

“…However, in the setting of MS, even though certain biomarkers suggest differences in the profiles of RRMS, PPMS, and SPMS patients, there is still not enough pathological evidence of clear differences between each disease phenotype (10). The only difference related to structural markers seems so far to be more at a quantitative than qualitative level (11). The neuroand immunopathological structural changes are apparently common in all MS subtypes with individual differences of their contribution to the clinical phenotype rather due to the burden of these lesions than to different pathological characteristics (11).…”

“…The only difference related to structural markers seems so far to be more at a quantitative than qualitative level (11). The neuroand immunopathological structural changes are apparently common in all MS subtypes with individual differences of their contribution to the clinical phenotype rather due to the burden of these lesions than to different pathological characteristics (11).…”

Disease Progression in Multiple Sclerosis: A Literature Review Exploring Patient Perspectives

“…4,5 Bodily systems in which MS progression can be detected continue to be elucidated. 6 Lublin et al suggest using "worsening" rather than "progressing" for patients with relapsing MS, reserving "progression" for those with clinically defined progressive disease 2 -a recommendation adopted here.…”