The transition from relapsing-remitting MS to irreversible disability: clinical evaluation.
The development of a progressive course is by far the most deleterious event in the case of a multiple sclerosis (MS) patient. It occurs in about 90% of relapsing remitting patients by 20-25 years from onset. The clinical transition to secondary progressive MS is phenotypically distinctive and both patients and physicians acknowledge that a fundamental shift in the degree of responsiveness to anti-inflammatory therapies has occurred. This review discusses the clinical studies that provided important findings relating to our understanding on different mechanisms that may contribute to irreversible disability in MS.
Trojano
M
M
Department of Neurological and Psychiatric Sciences, University of Bari, Piazza Giulio Cesare 11, I-70124, Bari, Italy.
Paolicelli
D
D
Bellacosa
A
A
Cataldo
S
S
D000328:Adult; D000367:Age Factors; D002986:Clinical Trials as Topic; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D020528:Multiple Sclerosis, Chronic Progressive / Q000503:physiopathology*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000503:physiopathology*