Secondary Progressive Multiple Sclerosis: A Review of Clinical Characteristics, Definition, Prognostic Tools, and Disease-Modifying Therapies

Neurol Neuroimmunol Neuroinflamm. 2022 Nov 22;10(1):e200064. doi: 10.1212/NXI.0000000000200064. Print 2023 Jan.


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.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Multiple Sclerosis*
  • Multiple Sclerosis, Chronic Progressive* / diagnosis
  • Multiple Sclerosis, Chronic Progressive* / drug therapy
  • Prognosis
  • Prospective Studies
  • Retrospective Studies