PT - JOURNAL ARTICLE AU - Ziemssen, Tjalf AU - Bhan, Virender AU - Chataway, Jeremy AU - Chitnis, Tanuja AU - Campbell Cree, Bruce Anthony AU - Havrdova, Eva Kubala AU - Kappos, Ludwig AU - Labauge, Pierre AU - Miller, Aaron AU - Nakahara, Jin AU - Oreja-Guevara, Celia AU - Palace, Jacqueline AU - Singer, Barry AU - Trojano, Maria AU - Patil, Ashwini AU - Rauser, Benedict AU - Hach, Thomas 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