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J Neurol Neurosurg Psychiatry doi:10.1136/jnnp-2012-303884
  • Cochrane Neurological Field Corner

Secondary progressive multiple sclerosis: a shared therapeutic decision

  1. Peter A G Sandercock3
  1. 1Cochrane Neurological Field, c/o Direzione salute, coesione sociale e società della conoscenza, Regione Umbria Perugia, Italy
  2. 2Department of Neurology, Royal Perth Hospital, Perth, Australia
  3. 3Department of Clinical Neurosciences, Western General Hospital, Edinburgh Neuroscience, Edinburgh, UK
  1. Correspondence to Dr Teresa Anna Cantisani, Cochrane Neurological Field, Perugia, Italy; cochrane.neuronet{at}regione.umbria.it
  • Received 18 September 2012
  • Accepted 24 September 2012
  • Published Online First 6 December 2012

Over a 15 year period, half of patients with relapsing remitting multiple sclerosis (RR-MS) will develop secondary progressive-multiple sclerosis (SP-MS). Recombinant beta interferons (IFN-β) are well established for relapsing remitting-multiple sclerosis (RR-MS) but often they continue to be used as the first line treatment in the secondary progressive phase of the disease (SP- MS), without good evidence that they reverse or retard the progression of the disease.

There are several reasons why IFN-beta (IFN-β) are used in SP-MS: perception of clinical efficacy of IFN-β in SP-MS, difficulty informing the patient about the worsening of the condition in the progressive phase of the disease, the ‘force of habit’ of the clinician and the patient, and the current absence of therapeutic agents able to significantly change …

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