You asked what ProfG thinks of this paper.
To answer that question
I don't think much
Paper
Coret F, Pérez-Miralles FC, Gascón F, Alcalá C, Navarré A, Bernad A, Boscá I, Escutia M, Gil-Perotin S, Casanova B. Onset of secondary progressive multiple sclerosis is not influenced by current relapsing multiple sclerosis therapies.Mult Scler J Exp Transl Clin. 2018 Jun 26;4(2):2055217318783347.BACKGROUND: Disease-modifying therapies are thought to reduce the conversion rate to secondary progressive multiple sclerosis.
OBJECTIVE:To explore the rate, chronology, and contributing factors of conversion to the progressive phase in treated relapsing-remitting multiple sclerosis patients.
METHODS: Our study included 204 patients treated for relapsing-remitting multiple sclerosis between 1995 and 2002, prospectively followed to date. Kaplan-Meier analysis was applied to estimate the time until secondary progressive multiple sclerosis conversion.
RESULTS: Relapsing-remitting multiple sclerosis patients were continuously treated for 13 years (SD 4.5); 36.3% converted to secondary progressive multiple sclerosis at a mean age of 42.6 years (SD 10.6), a mean time of 8.2 years (SD 5.2) and an estimated mean time of 17.2 years (range 17.1-18.1). A multifocal relapse, age older than 34 years at disease onset and treatment failure independently predicted conversion to secondary progressive multiple sclerosis but did not influence the time to reach an Expanded Disability Status Scale of 6.0.
CONCLUSIONS: The favourable influence of disease-modifying therapies on long-term disability in relapsing-remitting multiple sclerosis is well established. However, the time to progression onset and the subsequent clinical course in treated patients seem similar to those previously reported in natural history studies. More studies are needed to clarify the effect of disease-modifying therapies once the progressive phase has been reached.
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I think the title is misleading as it states that current DMT do not stop progressive MS from occurring. However, the census period was 1995-2002 and so simply read it as 'CRAB drugs do not halt progression'. However you know my views and I would replace the B with a P. The CRAB drugs were and are simply not potent enough so really get disease under control for most pwMS.
Therefore, I don't want to spend time discussing conclusions based these agents. ProfG will say look at the survival time the CRAB drugs improved it. So they aren't inert.
Not sure if these investigators understand that SPMS is an artificial (Pharma invented) construct and that progressive MS is there from the beginning; it doesn't suddenly come on. When is the community going to accept that #MS_is_1_not_2_or_3_diseases? https://buff.ly/2vZP6jF