Understanding Multiple Sclerosis (MS) Progression: Beyond Traditional Phenotypes

In the first episode, the discussion introduces the panel, with Dr. Stephen Krieger moderating and colleagues Dr. Benjamin Greenberg, Dr. Jiwon Oh, Dr. Ann Bass, and Dr. Barry Singer joining. The group focuses initially on the complexity and evolving understanding of MS (multiple sclerosis) disease progression, beginning with an overview of traditional MS phenotypes: relapsing-remitting MS (RRMS), secondary progressive MS (SPMS), and primary progressive MS (PPMS). Dr. Singer explains that most patients start with RRMS and can transition into SPMS, while a smaller subset develops PPMS. The conversation details the introduction of new ICD-10 codes that now require clinicians to classify MS patients as having active or inactive forms of progressive disease. The panelists highlight an ongoing shift within the neurology community from viewing MS as discrete phenotypes to understanding it as a disease spectrum, emphasizing that traditional labels may not fully capture the individual clinical reality for each patient.