The following is a summary of “Active and non-active secondary progressive multiple sclerosis patients exhibit similar disability progression: results of an Italian MS registry study (ASPERA),” published in the August 2024 issue of Neurology by Chisari et al.
‘Active’ and ‘non-active’ secondary progressive multiple sclerosis MS (SPMS) have different pathophysiological mechanisms and clinical traits. However, no agreement exists on how often these types occur in real-world settings. Understanding these frequencies and their clinical implications is crucial for better treatment and management.
Researchers conducted a retrospective study assessing the prevalence of ‘active’ and ‘non-active’ SPMS in a large group of Italian patients with MS. It also sought to explore differences in clinical and MRI features and disease progression between the two forms of SPMS.
They gathered data from patients with MS who transitioned to SPMS between January 1, 2014, and December 31, 20109. The patients were monitored by MS centers that contributed to the Italian MS registry. Patients were classified as ‘active SPMS’ or ‘non-active SPMS’ based on MRI findings and relapse activity the year before their SPMS diagnosis.
The results showed that out of 68,621 patients, 8,316 (12.1%) had SPMS. Of these, 872 (10.5%) were categorized as either ‘active’ (n= 237 or 27.2%) or ‘non-active’ SPMS (n= 635 or 72.8%). Patients with ‘Non-active SPMS’ were older and had a longer disease duration. Progression independent of relapse activity (PIRA) was similar in both groups at 24 months (67 [27.4%] vs. 188 [29.6%], P=0.60). In the ‘active’ group, 36 (15.2%) patients had relapse-associated worsening (RAW). Survival to EDSS 6 and 7 showed no significant differences based on disease activity (P=0.68 and P=0.71).
Investigators concluded that patients with both ‘active’ and ‘non-active’ SPMS had similar risks for reaching disability milestones, indicating that progression is mainly driven by PIRA rather than disease activity.
Source: link.springer.com/article/10.1007/s00415-024-12621-9
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