PT  - JOURNAL ARTICLE
AU  - Tjalf Ziemssen
AU  - Virender Bhan
AU  - Jeremy Chataway
AU  - Tanuja Chitnis
AU  - Bruce Anthony Campbell Cree
AU  - Eva Kubala Havrdova
AU  - Ludwig Kappos
AU  - Pierre Labauge
AU  - Aaron Miller
AU  - Jin Nakahara
AU  - Celia Oreja-Guevara
AU  - Jacqueline Palace
AU  - Barry Singer
AU  - Maria Trojano
AU  - Ashwini Patil
AU  - Benedict Rauser
AU  - Thomas Hach
TI  - Secondary Progressive Multiple Sclerosis
AID  - 10.1212/NXI.0000000000200064
DP  - 2023 Jan 01
TA  - Neurology - Neuroimmunology Neuroinflammation
PG  - e200064
VI  - 10
IP  - 1
4099  - http://nn.neurology.org/content/10/1/e200064.short
4100  - http://nn.neurology.org/content/10/1/e200064.full
SO  - Neurol Neuroimmunol Neuroinflamm2023 Jan 01; 10
AB  - Many challenges exist in the precise diagnosis and clinical management of secondary progressive multiple sclerosis (SPMS) because of the lack of definitive clinical, imaging, immunologic, or pathologic criteria that demarcate the transition from relapsing-remitting MS to SPMS. This review provides an overview of the diagnostic criteria/definition and the heterogeneity associated with different SPMS patient populations; it also emphasizes the importance of available prospective/retrospective tools to identify patients with SPMS earlier in the disease course so that approved disease-modifying therapies and nonpharmacological strategies will translate into better outcomes. Delivery of such interventions necessitates an evolving patient-clinician dialog within the context of a multidisciplinary team.ARR=annualized relapse rate; CDW=confirmed disability worsening; DMTs=disease-modifying therapies; DSP=Disease-Specific Programme; EDSS=Expanded Disability Status Scale; EU=European Union; GFAP=glial fibrillary acidic protein; IFN-β=interferon-beta; IQR=interquartile range; MS=multiple sclerosis; MSFC=MS functional composite; NA=North American; OCT=optical coherence tomography; PIRA=progression independent of relapse activity; PRO=patient-reported outcome; RCN=research collaboration network; RNFL=retinal fiber layer; RRMS=relapsing-remitting MS; SPMS=secondary progressive MS