Treatment for patients with primary progressive and progressive-relapsing multiple sclerosis

Patients with primary progressive multiple scler­ osis (PPMS) are a unique group with atypical clinical and magnetic resonance imaging (MRI) characteristics, and this has resulted in their exclusion from the majority of therapeutic trials. This chapter discusses these characteristics and their implications for treatment and clinical trials, particularly in regard to patient selection and therapeutic monitoring. Additionally, thera­ peutic trials to date for PPMS are reviewed.