Abstract
Multiple sclerosis is a serious autoimmune disorder of the central nervous system, whose phenotypes are traditionally classified as relapsing or progressive. According to the contemporary knowledge, both inflammation and neurodegeneration are present from the onset of the disease and differ only in clinical presentation.
Primary and secondary progression lead to slow accumulation of irreversible neurological disability. Long-term clinical experience and data analyses from registries and databases showed that early anti-inflammatory therapy is effective in mitigating the neurodegenerative component of MS even in the later stages of the disease.
However, an objective, reproducible definition of secondary progression is still warranted, to enable a timely initiation of its pharmacological management. Active treatment of MS with highly effective drugs, especially when started early, considerably delays the clinical progressive phase of the disease and improves the prognosis among patients living with MS