Current treatments for primary and secondary progressive multiple sclerosis

Xavier Montalban, MD, PhD, MBA, Vall d’Hebron University Hospital, Barcelona, Spain, discusses the current treatments for primary and secondary progressive multiple sclerosis (MS). Ocrelizumab is the only approved drug for primary progressive MS (PPMS) and was found in the ORATORIO trial (NCT01194570) to be associated with a 24% reduction in disability progression; however, addressing patient comorbidities and lifestyle and environmental factors such as smoking is equally important. Ocrelizumab is also used to treat secondary progressive MS (SPMS), where oral cladribine, interferon beta-1a, and interferon beta-1b are also recommended. There were few clinical trials available regarding SPMS. The European multicenter trial on interferon beta-1b concluded that the treatment was effective in patients with SPMS, but later, the American study was negative. One other trial on SMPS derived more positive results for siponimod. Overall, further studies need to be conducted to identify more effective treatments for PPMS and SPMS. This interview took place during the XXV World Congress of Neurology (WCN).