Secondary progressive multiple sclerosis (SPMS) is a second stage of MS that follows relapsing-remitting multiple sclerosis (RRMS). Around 65% of people with RRMS will develop SPMS about 15 years after RRMS diagnosis.
Establishing SPMS diagnosis can be challenging to neurologists because at least six months of progression must be observed before RRMS can be considered secondary progressive. The worsening of symptoms could be due to a relapse that caused permanent but stable damage after an inflammatory attack ended. In that case, the patient is still in the RRMS phase — or there was a worsening of the condition without inflammatory relapses. Repeat brain MRI scans and a neurologic examination can help determine if the disease has actually progressed to SPMS.
SPMS can be characterized as not active, active (with relapses or evidence of new brain MRI lesions), without progression, or with progression (when there is evidence of worsening of the disease over time, with or without relapses).
People diagnosed with SPMS who are on disease-modifying therapies for MS can often continue taking them. The medications include:
Dimethyl fumarate (Tecfidera)
One FDA approved chemotherapeutic agent, Novantrone (mitoxantrone) made specifically for SPMS (and for worsening relapsing MS), suppresses the immune system. While there is significant unmet need for SPMS treatments, promising therapies are currently progressing through the research and development pipeline.
There are ways for SPMS patients to help manage the disease. Appropriate exercise and healthy eating habits are important for all people with MS. When relapse or worsening of symptoms occur, physical and occupational therapy can help minimize muscle weakness and help restore movement.
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