Unmet needs and gaps in the identification of secondary progression in multiple sclerosis: a Southern Italy healthcare professionals’ perspective

Abstract

Objective Multiple sclerosis (MS) is a chronic disease with different clinical courses and a tendency to worsening. The relapsing–remitting MS presents acute onset and relapses of neurological symptoms, followed by their remission. This form can convert to secondary progressive MS (SPMS) with irreversible neurological worsening and disability. The identification of signs, symptoms, markers of progression, and strategies to manage MS patients is mandatory to allow early identification of those at higher risk of conversion to SPMS, for prompt intervention to cope with the progression of the disease. Methods A panel of Italian experts from Southern Italy have reviewed the current knowledge on MS and its management and identified the crucial tools for SPMS recognition. Results More effective communication between patients and clinicians should be established, with the support of digital tools. Moreover, the improvement in the clinical use of biomarkers for progression (cellular structures and tissue organization, such as neurofilaments and chitinase 3-like 1, axonal and neurons density) and of instrumental analyses for recognition of whole-brain atrophy, chronic active lesions, spinal cord lesions and atrophy, and the improvement the combination of the Expanded Disability Status Scale and the evaluation of cognitive dysfunction are discussed. Conclusion Given the availability of a pharmacological option, adequate education both for patients, regarding the evolution of the disease and the specific treatment, and for professionals, to allow more effective and sensitive communication and the best use of diagnostic and management tools, could represent a strategy to improve patient management and their quality of life.

Treatment of older patients with multiple sclerosis: Results of an International Delphi Survey

“…It is interesting that the prevention of cognitive decline was not commonly identified as a key unmet need by other researchers. 42 – 44 This study, along with others, may be useful in informing the development of evidence-based practice guidelines for older PwMS. Such guidelines are of critical importance to ensuring that this growing and underserved segment of the MS patient population is managed appropriately, so that they receive appropriate, timely, and effective treatment to maximize patient well-being and outcomes.…”

Cognitive impairment and its treatment in patients with multiple sclerosis

“…В связи с этим внедрение методов оценки КН в клиническую практику представляется исключительно важным для своевременного начала терапии обострения и смены ПИТРС. Кроме того, оценка когнитивных функций рекомендуется для увеличения точности определения перехода заболевания ко вторично прогрессирующему течению [21].…”