What Is the Treatment of Multiple Sclerosis in Active Secondary-Progressive Disease?
Clinical Scenario
This protocol applies to patients with active secondary-progressive multiple sclerosis (SPMS) — a stage in which the disease follows a progressive course with ongoing inflammatory activity, distinguishing these patients from those with non-active progressive MS.
Treatment Approach
For active secondary-progressive MS, interferon-based therapies are among the options considered in a shared decision-making process with the patient — with particular attention to their efficacy and tolerability in this population. Further systemic agents are also part of the treatment landscape; the full selection and the criteria that guide the choice between them are contained in the complete protocol.
References
DOI: 10.1177/1352458517751049
- Consider treatment with interferon-1a (sc) or -1b for patients with active secondary-progressive MS taking into account, in discussion with the patient, the dubious efficacy, as well as the safety and tolerability profile of these drugs.
- Consider treatment with mitoxantrone for patients with active secondary-progressive MS taking into account, in discussion with the patient, the efficacy, and specifically the safety and tolerability profile of this agent.
- Consider treatment with ocrelizumab or cladribine for patients with active secondary-progressive MS.
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