Recommendations from the Expert Meeting «Secondary progressive multiple sclerosis: unresolved issues and prospects»
Abstract
The meeting of experts discussed the clinical and pathophysiological features of secondary progressive multiple sclerosis (MS) (SPMS), clinical trials, and promising treatments for the progressive MS stage, as well as proposals contributing to the improvement of the current state of the problem of SPMS. In particular, the definition of and criteria for SPMS are formulated; the earliest period, when its confirmed progression can be recorded, is stated to be 3 months. The exacerbation-unaffected disability progression confirmed 6 months later may be considered to be more convincing. The introduction of tools for the early assessment of disability progression into routine practice will be able to identify the signs of progression at an earlier stage in order to timely change treatment policy. It is also noted that therapeutic possibilities in establishing secondary progression, especially in the absence of exacerbations, but in maintaining progression, are still insufficient. Certain hopes for slowing the progression in patients with SPMS are associated with the advent of siponimod, a new molecular class of S1P receptor modulators. The confirmed efficiency of siponimod in a large population of patients with SPMS allows the latter to be recommended for its treatment with both persistent disease activity (SPMS with exacerbations) and disability progression without exacerbations (SPMS without exacerbations).
About the Authors
N. V. Khachanova
Department of Neurology, Neurosurgery, and Medical Genetics, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation
1, Ostrovityanov St., Moscow 117997
Russian Federation
1, Ostrovityanov St., Moscow 117997
A. N. Boyko
Department of Neurology, Neurosurgery, and Medical Genetics, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia;
Department of Neuroimmunology, Federal Center for Cerebrovascular Pathology and Stroke, Ministry of Health of Russia
Russian Federation
Russian Federation
1, Ostrovityanov St., Moscow 117997;
1, Ostrovityanov St., Build. 10, Moscow 117997
K. Z. Bakhtiyarova
Bashkir State Medical University, Ministry of Health of Russia
Russian Federation
47, Zaki Validi St., Ufa 450008
Russian Federation
47, Zaki Validi St., Ufa 450008
Ya. V. Vlasov
Department of Neurology and Neurosurgery, Samara State Medical University, Ministry of Health of Russia
Russian Federation
89, Chapaevskaya St., Samara 443099
Russian Federation
89, Chapaevskaya St., Samara 443099
E. P. Evdoshenko
City Center for Multiple Sclerosis City Clinical Hospital Thirty-One
Russian Federation
3, Dynamo Pr., Saint Petersburg 197110
Russian Federation
3, Dynamo Pr., Saint Petersburg 197110
S. A. Sivertseva
«Neftyanik» Primary Healthcare Unit, Tyumen Regional Center for Multiple Sclerosis
Russian Federation
12, Schiller St., Tyumen 625000
Russian Federation
12, Schiller St., Tyumen 625000
T. E. Schmidt
Department of Nervous System Diseases and Neurosurgery, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
11, Rossolimo St., Build. 1, Moscow 119021
Russian Federation
11, Rossolimo St., Build. 1, Moscow 119021
M. V. Shumilina
City Center for Multiple Sclerosis City Clinical Hospital Thirty-One
Russian Federation
3, Dynamo Pr., Saint Petersburg 197110
Russian Federation
3, Dynamo Pr., Saint Petersburg 197110
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Review
For citations:
Khachanova N.V., Boyko A.N., Bakhtiyarova K.Z., Vlasov Y.V., Evdoshenko E.P., Sivertseva S.A., Schmidt T.E., Shumilina M.V. Recommendations from the Expert Meeting «Secondary progressive multiple sclerosis: unresolved issues and prospects». Neurology, Neuropsychiatry, Psychosomatics. 2019;11(4):172-175. (In Russ.) https://doi.org/10.14412/2074-2711-2019-4-172-175
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