Updates in the Diagnosis and Management of Primary Progressive Multiple Sclerosis: Patricia K. Coyle, MD


The professor of neurology at Stony Brook Medicine talked about the diagnosis of primary progressive multiple sclerosis, a unique MS phenotype characterized by a gradual deterioration without initial attack. [WATCH TIME: 5 minutes]

WATCH TIME: 5 minutes

"Progressive MS is that identical neurodegenerative, smoldering inflammation process, and thus you can combine patients in progressive trials and say, if this works in primary progressive MS, it'll work in secondary progressive MS and vice versa. This is current thinking, and there's a huge focus on this because we do not have good treatments for progressive MS at all. "

Multiple sclerosis (MS), a chronic autoimmune disease of the central nervous system, can result in patients experiencing different degrees of disability. Progressive MS, a form of MS recognized as a steady increase in neurological disability independently of relapses, can occur in patients from onset, known as primary progressive MS, or following a relapsing–remitting course, known as secondary progressive MS. In contrast to the active inflammation observed in the relapsing–remitting phases of this disease, the gradual worsening of disability in progressive MS is caused from complex immune mechanisms and neurodegeneration.

For the treatment of progressive MS, research shows that there are a limited number of anti-inflammatory disease-modifying therapies approved for patients. Thus, there is a significant effort in the field now to develop molecules with the potential to induce myelin repair or halt the degenerative process in progressive MS.1 As observed in clinical trials, the design of the studies and clinically meaningful disability outcome measures have had a significant impact on the ability to measure the efficacy of potential medications to potentially reverse disease progression.

At the 2024 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, held May 29 to June 1, in Nashville, Tennessee, Patricia K. Coyle, MD, professor of neurology at Stony Brook Medicine, presented a talk on the diagnosis, clinical course, and management of primary progressive MS. Following the meeting, Coyle sat down in an interview with NeurologyLive® to discuss how the diagnostic criteria for primary progressive MS differ from other MS phenotypes. She also talked about the key pathological features underlying the gradual deterioration in patients with this condition. Moreover, Coyle spoke about why holistic management, including lifestyle changes, is crucial for these patients.

Click here for more coverage of CMSC 2024.

1. Macaron G, Ontaneda D. Diagnosis and Management of Progressive Multiple Sclerosis. Biomedicines. 2019;7(3):56. Published 2019 Jul 29. doi:10.3390/biomedicines7030056
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