How to measure the treatment response in progressive multiple sclerosis: Current perspectives and limitations in clinical settings'

New treatment options are available for active progressive multiple sclerosis (MS), including primary and secondary progressive forms. Several pieces of evidence have recently suggested a window of beneficial treatment opportunities, principally in the early stages of progression. However, for progressive MS, which is characterised by an inevitable tendency to get worse, it is crucial to redefine the response to treatment beyond the concept of no evidence of disease activity (NEDA-3), which was initially conceived to evaluate disease outcomes in relapsing-remitting form, albeit it is currently applied to all MS cases in clinical practice. This review examines the current perspectives and limitations in assessing the effectiveness of DMTs and disease outcomes in progressive MS, the current criteria applied in defining the response to DMTs, and the strengths and limitations of clinical scales and tools for evaluating MS evolution and patient perception. Additionally, the impact of age and comorbidities on the assessment of MS outcomes was examined.

Automated summary

New treatment options for active progressive MS have shown potential benefits, especially in the early stages of the disease. Evaluating the response to treatment in progressive MS goes beyond the concept of NEDA-3, which was initially designed for relapsing-remitting cases. This review explores the current perspectives and limitations in assessing treatment effectiveness, defining response criteria, and evaluating MS progression and patient perception.