January 2023; 10 (1) ReviewOpen Access
Secondary Progressive Multiple Sclerosis
A Review of Clinical Characteristics, Definition, Prognostic Tools, and Disease-Modifying Therapies
View ORCID ProfileTjalf Ziemssen, Virender Bhan, Jeremy Chataway, Tanuja Chitnis, View ORCID ProfileBruce Anthony Campbell Cree, Eva Kubala Havrdova, Ludwig Kappos, Pierre Labauge, Aaron Miller, Jin Nakahara, View ORCID ProfileCelia Oreja-Guevara, Jacqueline Palace, Barry Singer, Maria Trojano, Ashwini Patil, Benedict Rauser, View ORCID ProfileThomas Hach
First published November 22, 2022, DOI: https://doi.org/10.1212/NXI.0000000000200064
Tjalf Ziemssen
From the Center of Clinical Neuroscience (T.Z.), Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany; Division of Neurology (Medicine) (V.B.), University of British Columbia, Vancouver, Canada; Queen Square Multiple Sclerosis Centre (J.C.), UCL Queen Square Institute of Neurology, London, United Kingdom; Partners Pediatric Multiple Sclerosis Centre (T.C.), Massachusetts General Hospital, Boston; Department of Neurology (B.A.C.C.), Weill Institute for Neurosciences, UCSF, San Francisco, CA; Department of Neurology and Center of Clinical Neuroscience (E.K.H.), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Neurologic Clinic and Policlinic (L.K.), Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Switzerland; Multiple Sclerosis Clinic (P.L.), Department of Neurology, Montpellier University Hospital, France; Department of Neurology (A.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.N.), Keio University School of Medicine, Tokyo, Japan; Department of Neurology (C.O.-G.), Hospital Clinico San Carlos, IdISSC, Departametno de medicina, Universidad Complutense de Madrid, Spain; Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom; The MS Center for Innovations in Care (B.S.), Missouri Baptist Medical Center, St Louis, MO; Department of Basic Medical Sciences (M.T.), Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Novartis Healthcare Pvt. Ltd. (A.P.), Hyderabad, India; Novartis Pharma GmbH (B.R.), Nuremberg, Germany; and Novartis Pharma AG (T.H.), Basel, Switzerland.
MDVirender Bhan
From the Center of Clinical Neuroscience (T.Z.), Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany; Division of Neurology (Medicine) (V.B.), University of British Columbia, Vancouver, Canada; Queen Square Multiple Sclerosis Centre (J.C.), UCL Queen Square Institute of Neurology, London, United Kingdom; Partners Pediatric Multiple Sclerosis Centre (T.C.), Massachusetts General Hospital, Boston; Department of Neurology (B.A.C.C.), Weill Institute for Neurosciences, UCSF, San Francisco, CA; Department of Neurology and Center of Clinical Neuroscience (E.K.H.), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Neurologic Clinic and Policlinic (L.K.), Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Switzerland; Multiple Sclerosis Clinic (P.L.), Department of Neurology, Montpellier University Hospital, France; Department of Neurology (A.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.N.), Keio University School of Medicine, Tokyo, Japan; Department of Neurology (C.O.-G.), Hospital Clinico San Carlos, IdISSC, Departametno de medicina, Universidad Complutense de Madrid, Spain; Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom; The MS Center for Innovations in Care (B.S.), Missouri Baptist Medical Center, St Louis, MO; Department of Basic Medical Sciences (M.T.), Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Novartis Healthcare Pvt. Ltd. (A.P.), Hyderabad, India; Novartis Pharma GmbH (B.R.), Nuremberg, Germany; and Novartis Pharma AG (T.H.), Basel, Switzerland.
MDJeremy Chataway
From the Center of Clinical Neuroscience (T.Z.), Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany; Division of Neurology (Medicine) (V.B.), University of British Columbia, Vancouver, Canada; Queen Square Multiple Sclerosis Centre (J.C.), UCL Queen Square Institute of Neurology, London, United Kingdom; Partners Pediatric Multiple Sclerosis Centre (T.C.), Massachusetts General Hospital, Boston; Department of Neurology (B.A.C.C.), Weill Institute for Neurosciences, UCSF, San Francisco, CA; Department of Neurology and Center of Clinical Neuroscience (E.K.H.), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Neurologic Clinic and Policlinic (L.K.), Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Switzerland; Multiple Sclerosis Clinic (P.L.), Department of Neurology, Montpellier University Hospital, France; Department of Neurology (A.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.N.), Keio University School of Medicine, Tokyo, Japan; Department of Neurology (C.O.-G.), Hospital Clinico San Carlos, IdISSC, Departametno de medicina, Universidad Complutense de Madrid, Spain; Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom; The MS Center for Innovations in Care (B.S.), Missouri Baptist Medical Center, St Louis, MO; Department of Basic Medical Sciences (M.T.), Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Novartis Healthcare Pvt. Ltd. (A.P.), Hyderabad, India; Novartis Pharma GmbH (B.R.), Nuremberg, Germany; and Novartis Pharma AG (T.H.), Basel, Switzerland.
PhDTanuja Chitnis
From the Center of Clinical Neuroscience (T.Z.), Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany; Division of Neurology (Medicine) (V.B.), University of British Columbia, Vancouver, Canada; Queen Square Multiple Sclerosis Centre (J.C.), UCL Queen Square Institute of Neurology, London, United Kingdom; Partners Pediatric Multiple Sclerosis Centre (T.C.), Massachusetts General Hospital, Boston; Department of Neurology (B.A.C.C.), Weill Institute for Neurosciences, UCSF, San Francisco, CA; Department of Neurology and Center of Clinical Neuroscience (E.K.H.), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Neurologic Clinic and Policlinic (L.K.), Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Switzerland; Multiple Sclerosis Clinic (P.L.), Department of Neurology, Montpellier University Hospital, France; Department of Neurology (A.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.N.), Keio University School of Medicine, Tokyo, Japan; Department of Neurology (C.O.-G.), Hospital Clinico San Carlos, IdISSC, Departametno de medicina, Universidad Complutense de Madrid, Spain; Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom; The MS Center for Innovations in Care (B.S.), Missouri Baptist Medical Center, St Louis, MO; Department of Basic Medical Sciences (M.T.), Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Novartis Healthcare Pvt. Ltd. (A.P.), Hyderabad, India; Novartis Pharma GmbH (B.R.), Nuremberg, Germany; and Novartis Pharma AG (T.H.), Basel, Switzerland.
MDBruce Anthony Campbell Cree
From the Center of Clinical Neuroscience (T.Z.), Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany; Division of Neurology (Medicine) (V.B.), University of British Columbia, Vancouver, Canada; Queen Square Multiple Sclerosis Centre (J.C.), UCL Queen Square Institute of Neurology, London, United Kingdom; Partners Pediatric Multiple Sclerosis Centre (T.C.), Massachusetts General Hospital, Boston; Department of Neurology (B.A.C.C.), Weill Institute for Neurosciences, UCSF, San Francisco, CA; Department of Neurology and Center of Clinical Neuroscience (E.K.H.), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Neurologic Clinic and Policlinic (L.K.), Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Switzerland; Multiple Sclerosis Clinic (P.L.), Department of Neurology, Montpellier University Hospital, France; Department of Neurology (A.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.N.), Keio University School of Medicine, Tokyo, Japan; Department of Neurology (C.O.-G.), Hospital Clinico San Carlos, IdISSC, Departametno de medicina, Universidad Complutense de Madrid, Spain; Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom; The MS Center for Innovations in Care (B.S.), Missouri Baptist Medical Center, St Louis, MO; Department of Basic Medical Sciences (M.T.), Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Novartis Healthcare Pvt. Ltd. (A.P.), Hyderabad, India; Novartis Pharma GmbH (B.R.), Nuremberg, Germany; and Novartis Pharma AG (T.H.), Basel, Switzerland.
MD, PhDEva Kubala Havrdova
From the Center of Clinical Neuroscience (T.Z.), Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany; Division of Neurology (Medicine) (V.B.), University of British Columbia, Vancouver, Canada; Queen Square Multiple Sclerosis Centre (J.C.), UCL Queen Square Institute of Neurology, London, United Kingdom; Partners Pediatric Multiple Sclerosis Centre (T.C.), Massachusetts General Hospital, Boston; Department of Neurology (B.A.C.C.), Weill Institute for Neurosciences, UCSF, San Francisco, CA; Department of Neurology and Center of Clinical Neuroscience (E.K.H.), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Neurologic Clinic and Policlinic (L.K.), Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Switzerland; Multiple Sclerosis Clinic (P.L.), Department of Neurology, Montpellier University Hospital, France; Department of Neurology (A.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.N.), Keio University School of Medicine, Tokyo, Japan; Department of Neurology (C.O.-G.), Hospital Clinico San Carlos, IdISSC, Departametno de medicina, Universidad Complutense de Madrid, Spain; Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom; The MS Center for Innovations in Care (B.S.), Missouri Baptist Medical Center, St Louis, MO; Department of Basic Medical Sciences (M.T.), Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Novartis Healthcare Pvt. Ltd. (A.P.), Hyderabad, India; Novartis Pharma GmbH (B.R.), Nuremberg, Germany; and Novartis Pharma AG (T.H.), Basel, Switzerland.
MDLudwig Kappos
From the Center of Clinical Neuroscience (T.Z.), Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany; Division of Neurology (Medicine) (V.B.), University of British Columbia, Vancouver, Canada; Queen Square Multiple Sclerosis Centre (J.C.), UCL Queen Square Institute of Neurology, London, United Kingdom; Partners Pediatric Multiple Sclerosis Centre (T.C.), Massachusetts General Hospital, Boston; Department of Neurology (B.A.C.C.), Weill Institute for Neurosciences, UCSF, San Francisco, CA; Department of Neurology and Center of Clinical Neuroscience (E.K.H.), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Neurologic Clinic and Policlinic (L.K.), Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Switzerland; Multiple Sclerosis Clinic (P.L.), Department of Neurology, Montpellier University Hospital, France; Department of Neurology (A.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.N.), Keio University School of Medicine, Tokyo, Japan; Department of Neurology (C.O.-G.), Hospital Clinico San Carlos, IdISSC, Departametno de medicina, Universidad Complutense de Madrid, Spain; Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom; The MS Center for Innovations in Care (B.S.), Missouri Baptist Medical Center, St Louis, MO; Department of Basic Medical Sciences (M.T.), Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Novartis Healthcare Pvt. Ltd. (A.P.), Hyderabad, India; Novartis Pharma GmbH (B.R.), Nuremberg, Germany; and Novartis Pharma AG (T.H.), Basel, Switzerland.
MDPierre Labauge
From the Center of Clinical Neuroscience (T.Z.), Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany; Division of Neurology (Medicine) (V.B.), University of British Columbia, Vancouver, Canada; Queen Square Multiple Sclerosis Centre (J.C.), UCL Queen Square Institute of Neurology, London, United Kingdom; Partners Pediatric Multiple Sclerosis Centre (T.C.), Massachusetts General Hospital, Boston; Department of Neurology (B.A.C.C.), Weill Institute for Neurosciences, UCSF, San Francisco, CA; Department of Neurology and Center of Clinical Neuroscience (E.K.H.), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Neurologic Clinic and Policlinic (L.K.), Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Switzerland; Multiple Sclerosis Clinic (P.L.), Department of Neurology, Montpellier University Hospital, France; Department of Neurology (A.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.N.), Keio University School of Medicine, Tokyo, Japan; Department of Neurology (C.O.-G.), Hospital Clinico San Carlos, IdISSC, Departametno de medicina, Universidad Complutense de Madrid, Spain; Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom; The MS Center for Innovations in Care (B.S.), Missouri Baptist Medical Center, St Louis, MO; Department of Basic Medical Sciences (M.T.), Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Novartis Healthcare Pvt. Ltd. (A.P.), Hyderabad, India; Novartis Pharma GmbH (B.R.), Nuremberg, Germany; and Novartis Pharma AG (T.H.), Basel, Switzerland.
PhDAaron Miller
From the Center of Clinical Neuroscience (T.Z.), Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany; Division of Neurology (Medicine) (V.B.), University of British Columbia, Vancouver, Canada; Queen Square Multiple Sclerosis Centre (J.C.), UCL Queen Square Institute of Neurology, London, United Kingdom; Partners Pediatric Multiple Sclerosis Centre (T.C.), Massachusetts General Hospital, Boston; Department of Neurology (B.A.C.C.), Weill Institute for Neurosciences, UCSF, San Francisco, CA; Department of Neurology and Center of Clinical Neuroscience (E.K.H.), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Neurologic Clinic and Policlinic (L.K.), Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Switzerland; Multiple Sclerosis Clinic (P.L.), Department of Neurology, Montpellier University Hospital, France; Department of Neurology (A.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.N.), Keio University School of Medicine, Tokyo, Japan; Department of Neurology (C.O.-G.), Hospital Clinico San Carlos, IdISSC, Departametno de medicina, Universidad Complutense de Madrid, Spain; Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom; The MS Center for Innovations in Care (B.S.), Missouri Baptist Medical Center, St Louis, MO; Department of Basic Medical Sciences (M.T.), Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Novartis Healthcare Pvt. Ltd. (A.P.), Hyderabad, India; Novartis Pharma GmbH (B.R.), Nuremberg, Germany; and Novartis Pharma AG (T.H.), Basel, Switzerland.
MDJin Nakahara
From the Center of Clinical Neuroscience (T.Z.), Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany; Division of Neurology (Medicine) (V.B.), University of British Columbia, Vancouver, Canada; Queen Square Multiple Sclerosis Centre (J.C.), UCL Queen Square Institute of Neurology, London, United Kingdom; Partners Pediatric Multiple Sclerosis Centre (T.C.), Massachusetts General Hospital, Boston; Department of Neurology (B.A.C.C.), Weill Institute for Neurosciences, UCSF, San Francisco, CA; Department of Neurology and Center of Clinical Neuroscience (E.K.H.), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Neurologic Clinic and Policlinic (L.K.), Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Switzerland; Multiple Sclerosis Clinic (P.L.), Department of Neurology, Montpellier University Hospital, France; Department of Neurology (A.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.N.), Keio University School of Medicine, Tokyo, Japan; Department of Neurology (C.O.-G.), Hospital Clinico San Carlos, IdISSC, Departametno de medicina, Universidad Complutense de Madrid, Spain; Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom; The MS Center for Innovations in Care (B.S.), Missouri Baptist Medical Center, St Louis, MO; Department of Basic Medical Sciences (M.T.), Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Novartis Healthcare Pvt. Ltd. (A.P.), Hyderabad, India; Novartis Pharma GmbH (B.R.), Nuremberg, Germany; and Novartis Pharma AG (T.H.), Basel, Switzerland.
MD, PhDCelia Oreja-Guevara
From the Center of Clinical Neuroscience (T.Z.), Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany; Division of Neurology (Medicine) (V.B.), University of British Columbia, Vancouver, Canada; Queen Square Multiple Sclerosis Centre (J.C.), UCL Queen Square Institute of Neurology, London, United Kingdom; Partners Pediatric Multiple Sclerosis Centre (T.C.), Massachusetts General Hospital, Boston; Department of Neurology (B.A.C.C.), Weill Institute for Neurosciences, UCSF, San Francisco, CA; Department of Neurology and Center of Clinical Neuroscience (E.K.H.), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Neurologic Clinic and Policlinic (L.K.), Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Switzerland; Multiple Sclerosis Clinic (P.L.), Department of Neurology, Montpellier University Hospital, France; Department of Neurology (A.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.N.), Keio University School of Medicine, Tokyo, Japan; Department of Neurology (C.O.-G.), Hospital Clinico San Carlos, IdISSC, Departametno de medicina, Universidad Complutense de Madrid, Spain; Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom; The MS Center for Innovations in Care (B.S.), Missouri Baptist Medical Center, St Louis, MO; Department of Basic Medical Sciences (M.T.), Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Novartis Healthcare Pvt. Ltd. (A.P.), Hyderabad, India; Novartis Pharma GmbH (B.R.), Nuremberg, Germany; and Novartis Pharma AG (T.H.), Basel, Switzerland.
MD, PhDJacqueline Palace
From the Center of Clinical Neuroscience (T.Z.), Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany; Division of Neurology (Medicine) (V.B.), University of British Columbia, Vancouver, Canada; Queen Square Multiple Sclerosis Centre (J.C.), UCL Queen Square Institute of Neurology, London, United Kingdom; Partners Pediatric Multiple Sclerosis Centre (T.C.), Massachusetts General Hospital, Boston; Department of Neurology (B.A.C.C.), Weill Institute for Neurosciences, UCSF, San Francisco, CA; Department of Neurology and Center of Clinical Neuroscience (E.K.H.), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Neurologic Clinic and Policlinic (L.K.), Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Switzerland; Multiple Sclerosis Clinic (P.L.), Department of Neurology, Montpellier University Hospital, France; Department of Neurology (A.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.N.), Keio University School of Medicine, Tokyo, Japan; Department of Neurology (C.O.-G.), Hospital Clinico San Carlos, IdISSC, Departametno de medicina, Universidad Complutense de Madrid, Spain; Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom; The MS Center for Innovations in Care (B.S.), Missouri Baptist Medical Center, St Louis, MO; Department of Basic Medical Sciences (M.T.), Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Novartis Healthcare Pvt. Ltd. (A.P.), Hyderabad, India; Novartis Pharma GmbH (B.R.), Nuremberg, Germany; and Novartis Pharma AG (T.H.), Basel, Switzerland.
MD, PhDBarry Singer
From the Center of Clinical Neuroscience (T.Z.), Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany; Division of Neurology (Medicine) (V.B.), University of British Columbia, Vancouver, Canada; Queen Square Multiple Sclerosis Centre (J.C.), UCL Queen Square Institute of Neurology, London, United Kingdom; Partners Pediatric Multiple Sclerosis Centre (T.C.), Massachusetts General Hospital, Boston; Department of Neurology (B.A.C.C.), Weill Institute for Neurosciences, UCSF, San Francisco, CA; Department of Neurology and Center of Clinical Neuroscience (E.K.H.), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Neurologic Clinic and Policlinic (L.K.), Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Switzerland; Multiple Sclerosis Clinic (P.L.), Department of Neurology, Montpellier University Hospital, France; Department of Neurology (A.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.N.), Keio University School of Medicine, Tokyo, Japan; Department of Neurology (C.O.-G.), Hospital Clinico San Carlos, IdISSC, Departametno de medicina, Universidad Complutense de Madrid, Spain; Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom; The MS Center for Innovations in Care (B.S.), Missouri Baptist Medical Center, St Louis, MO; Department of Basic Medical Sciences (M.T.), Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Novartis Healthcare Pvt. Ltd. (A.P.), Hyderabad, India; Novartis Pharma GmbH (B.R.), Nuremberg, Germany; and Novartis Pharma AG (T.H.), Basel, Switzerland.
MDMaria Trojano
From the Center of Clinical Neuroscience (T.Z.), Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany; Division of Neurology (Medicine) (V.B.), University of British Columbia, Vancouver, Canada; Queen Square Multiple Sclerosis Centre (J.C.), UCL Queen Square Institute of Neurology, London, United Kingdom; Partners Pediatric Multiple Sclerosis Centre (T.C.), Massachusetts General Hospital, Boston; Department of Neurology (B.A.C.C.), Weill Institute for Neurosciences, UCSF, San Francisco, CA; Department of Neurology and Center of Clinical Neuroscience (E.K.H.), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Neurologic Clinic and Policlinic (L.K.), Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Switzerland; Multiple Sclerosis Clinic (P.L.), Department of Neurology, Montpellier University Hospital, France; Department of Neurology (A.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.N.), Keio University School of Medicine, Tokyo, Japan; Department of Neurology (C.O.-G.), Hospital Clinico San Carlos, IdISSC, Departametno de medicina, Universidad Complutense de Madrid, Spain; Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom; The MS Center for Innovations in Care (B.S.), Missouri Baptist Medical Center, St Louis, MO; Department of Basic Medical Sciences (M.T.), Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Novartis Healthcare Pvt. Ltd. (A.P.), Hyderabad, India; Novartis Pharma GmbH (B.R.), Nuremberg, Germany; and Novartis Pharma AG (T.H.), Basel, Switzerland.
MDAshwini Patil
From the Center of Clinical Neuroscience (T.Z.), Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany; Division of Neurology (Medicine) (V.B.), University of British Columbia, Vancouver, Canada; Queen Square Multiple Sclerosis Centre (J.C.), UCL Queen Square Institute of Neurology, London, United Kingdom; Partners Pediatric Multiple Sclerosis Centre (T.C.), Massachusetts General Hospital, Boston; Department of Neurology (B.A.C.C.), Weill Institute for Neurosciences, UCSF, San Francisco, CA; Department of Neurology and Center of Clinical Neuroscience (E.K.H.), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Neurologic Clinic and Policlinic (L.K.), Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Switzerland; Multiple Sclerosis Clinic (P.L.), Department of Neurology, Montpellier University Hospital, France; Department of Neurology (A.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.N.), Keio University School of Medicine, Tokyo, Japan; Department of Neurology (C.O.-G.), Hospital Clinico San Carlos, IdISSC, Departametno de medicina, Universidad Complutense de Madrid, Spain; Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom; The MS Center for Innovations in Care (B.S.), Missouri Baptist Medical Center, St Louis, MO; Department of Basic Medical Sciences (M.T.), Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Novartis Healthcare Pvt. Ltd. (A.P.), Hyderabad, India; Novartis Pharma GmbH (B.R.), Nuremberg, Germany; and Novartis Pharma AG (T.H.), Basel, Switzerland.
MSBenedict Rauser
From the Center of Clinical Neuroscience (T.Z.), Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany; Division of Neurology (Medicine) (V.B.), University of British Columbia, Vancouver, Canada; Queen Square Multiple Sclerosis Centre (J.C.), UCL Queen Square Institute of Neurology, London, United Kingdom; Partners Pediatric Multiple Sclerosis Centre (T.C.), Massachusetts General Hospital, Boston; Department of Neurology (B.A.C.C.), Weill Institute for Neurosciences, UCSF, San Francisco, CA; Department of Neurology and Center of Clinical Neuroscience (E.K.H.), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Neurologic Clinic and Policlinic (L.K.), Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Switzerland; Multiple Sclerosis Clinic (P.L.), Department of Neurology, Montpellier University Hospital, France; Department of Neurology (A.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.N.), Keio University School of Medicine, Tokyo, Japan; Department of Neurology (C.O.-G.), Hospital Clinico San Carlos, IdISSC, Departametno de medicina, Universidad Complutense de Madrid, Spain; Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom; The MS Center for Innovations in Care (B.S.), Missouri Baptist Medical Center, St Louis, MO; Department of Basic Medical Sciences (M.T.), Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Novartis Healthcare Pvt. Ltd. (A.P.), Hyderabad, India; Novartis Pharma GmbH (B.R.), Nuremberg, Germany; and Novartis Pharma AG (T.H.), Basel, Switzerland.
PhDThomas Hach
From the Center of Clinical Neuroscience (T.Z.), Department of Neurology, University Clinic Carl Gustav Carus, Dresden University of Technology, Germany; Division of Neurology (Medicine) (V.B.), University of British Columbia, Vancouver, Canada; Queen Square Multiple Sclerosis Centre (J.C.), UCL Queen Square Institute of Neurology, London, United Kingdom; Partners Pediatric Multiple Sclerosis Centre (T.C.), Massachusetts General Hospital, Boston; Department of Neurology (B.A.C.C.), Weill Institute for Neurosciences, UCSF, San Francisco, CA; Department of Neurology and Center of Clinical Neuroscience (E.K.H.), First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic; Neurologic Clinic and Policlinic (L.K.), Departments of Medicine, Clinical Research and Biomedicine, University Hospital Basel, University of Basel, Switzerland; Multiple Sclerosis Clinic (P.L.), Department of Neurology, Montpellier University Hospital, France; Department of Neurology (A.M.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.N.), Keio University School of Medicine, Tokyo, Japan; Department of Neurology (C.O.-G.), Hospital Clinico San Carlos, IdISSC, Departametno de medicina, Universidad Complutense de Madrid, Spain; Nuffield Department of Clinical Neurosciences (J.P.), John Radcliffe Hospital, University of Oxford, United Kingdom; The MS Center for Innovations in Care (B.S.), Missouri Baptist Medical Center, St Louis, MO; Department of Basic Medical Sciences (M.T.), Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Novartis Healthcare Pvt. Ltd. (A.P.), Hyderabad, India; Novartis Pharma GmbH (B.R.), Nuremberg, Germany; and Novartis Pharma AG (T.H.), Basel, Switzerland.
MDSecondary Progressive Multiple Sclerosis
A Review of Clinical Characteristics, Definition, Prognostic Tools, and Disease-Modifying Therapies
Tjalf Ziemssen, Virender Bhan, Jeremy Chataway, Tanuja Chitnis, Bruce Anthony Campbell Cree, Eva Kubala Havrdova, Ludwig Kappos, Pierre Labauge, Aaron Miller, Jin Nakahara, Celia Oreja-Guevara, Jacqueline Palace, Barry Singer, Maria Trojano, Ashwini Patil, Benedict Rauser, Thomas Hach
Neurol Neuroimmunol Neuroinflamm Jan 2023, 10 (1) e200064; DOI: 10.1212/NXI.0000000000200064
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