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:

Interferon beta (Avonex, Betaseron, Extavia, Plegridy and Rebif)

Teriflunomide (Aubagio)

Fingolimod (Gilenya)

Alemtuzumab (Lemtrada)

Dimethyl fumarate (Tecfidera)

Natalizumab (Tysabri)

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.

Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.



Muralist Lydia Emily Uses Art to Publicize Hardships of Life with MS

Perched atop a lift at the intersection of Main and Third streets in downtown Los Angeles, artist Lydia Emily cheerfully answered questions from a reporter 2,500 miles away via cellphone while working on a mural three stories high. Periodically, she interrupted the interview to banter with co-workers, and gawking passersby.

Her good humor belied the fact that Lydia Emily – her last name is Archibald, though she rarely uses it – takes up to 28 pills a day to ward off the constant pain associated with multiple sclerosis (MS), with which she was diagnosed in 2014. She also must drink two pots of coffee to counteract the drowsiness from all that pain medication.

But dealing with adversity is nothing new for Lydia Emily, 47. It’s a challenge she has embraced along with raising two daughters as a single mother, including a 16-year-old with autism, and overcoming cervical cancer in 2012.

Lydia Emily, a Chicago native who traveled the world with her parents before settling in Los Angeles 17 years ago, describes herself as a self-taught artist who flunked the only art class she ever took. Despite that initial setback, her work has been featured at shows in Milan, Berlin, Los Angeles, New York, Miami, Washington, D.C., and San Francisco.

Lydia Emily has always used her art to bring attention to international political and social issues, like sex trafficking and the displacement of people. She started as a street artist, but now focuses on murals and portraits.

“I was always socially conscious,” said the artist, whose mother was a civil rights activist. “My motto has always been, ‘art can do more than just hang. It can help.’”

‘MS On My Mind’

In recent years, Lydia Emily has added MS to her list of causes. Her largest project is ‘MS On My Mind,’ an effort funded by EMD Serono to highlight the emotional and physical toll MS takes on those with the disease, as well as their caregivers.

‘MS On My Mind’ encourages people to share their stories through its website. Using those stories, Lydia Emily — the campaign’s creative director — has painted five portraits that capture how MS affects people’s daily lives in ways that often are invisible to others.

In one painting, for instance, a woman dries her hair with a blow dryer resembling an anvil to illustrate how heavy things feel to those with MS. In another, the leg of a man sitting in a chair is painted as an anchor to highlight the common MS “drop foot” symptom that makes feet feel so heavy.

As part of the campaign, in 2015 Lydia Emily created large murals with hopeful messages for those affected by MS in four cities: Los Angeles, California; Houston, Texas; Portland, Oregon; and Louisville, Kentucky.

Recently, she painted portable eight-square-foot murals during Walk MS events in San Diego, California, Tampa, Florida, and Charlotte, North Carolina, that people could inscribe with their own messages. The three murals were shipped to Seattle, Washington, and assembled into one 24-foot-long mural.

In late April, Lydia Emily gave the keynote speech at the National MS Society’s 15th Annual On the Move luncheon in Washington, D.C., and also testified before the U.S. Senate on the need to control the rising prices of MS therapies.

Staying busy despite constant pain

“It’s a busy life, for sure,” she said. “I’m happy to be doing all the work I’m doing.”

Lydia Emily maintains a hectic schedule despite constant pain from MS. She became blind in her left eye a year ago. Her right leg feels like it’s on fire, and she uses a cane. She has to tie a paint brush to her hand because of her tremors.

She’s taken four MS medications, none of which have worked for her disease type, secondary progressive MS (SPMS). She’s about to start another medication, and is optimistic about its effectiveness.

Still, Lydia Emily loves her work and has many different projects going at once. For every mural she gets paid to do, she paints another using her own money, and for every portrait she gets paid for, she gives one away for free, she said.

On her own, Lydia Emily has painted murals with inspiring messages in various cities. The art-nouveau mural she was painting during her interview with MS News Today is for all those who deal with other kinds of challenges — from lupus to difficult relationships. They also need hope, she said.

“I feel like anything I can do to broaden our community,” said Lydia Emily. “Making our family bigger is what I want to do.”

Simvastatin, Common Statin, Treats SPMS in Ways Distinct from Cholesterol, Study Suggests

Simvastatin, a widely prescribed statin that works to lower cholesterol levels, may slow brain atrophy and disease progression in people with secondary progressive multiple sclerosis (SPMS) for reasons unrelated to changes in blood cholesterol, a new analysis of a Phase 2 clinical trial reports. These findings are in the study, “Applying causal models to explore the […]

#AANAM – Scoring Tool Helps Identify Patients with RRMS or Transitioning to SPMS, Study Reports

A newly developed scoring tool enables better identification of patients with relapsing-remitting multiple sclerosis (RRMS) as well as those transitioning or already diagnosed with secondary progressive MS (SPMS). The research about that finding, “Validation of the Scoring Algorithm for a Novel Integrative Secondary Progressive Multiple Sclerosis (SPMS) Screening Tool,” was presented at the 2019 American Academy […]

#AANAM – Mayzent Improves Cognitive Processing Speed in SPMS Patients, Trial Results Show

Treatment with Mayzent (siponimod) provided sustained improvements and prevented deterioration of cognitive processing speed in patients with secondary progressive multiple sclerosis (SPMS), regardless of their cognitive function prior to therapy, according to results of a Phase 3 clinical trial. The data were presented at the recent 2019 American Academy of Neurology (AAN) Annual Meeting in Philadelphia (May […]

#AANAM — Tysabri Lowers Serum Neurofilament Light Levels in SPMS Patients, Phase 3 Trial Finds

Treatment with Tysabri (natalizumab) lowers the levels of the biomarker serum neurofilament light chain (sNfL) in patients with secondary progressive multiple sclerosis (SPMS), according to data from a Phase 3 trial. Findings also revealed that higher levels of sNfL correlated with MS lesions and disease activity prior to starting the therapy, and with the extent of future […]

With an Autoimmune Disease, Fear of a Measles Outbreak Is Real

Few things scare me. I mean, truly frighten me to my core. While I flee from bees and scream at spiders, I have been both stung and bitten. Scary movies, no matter how asinine, freak me out. Being alone in the dark invokes vivid imagination. Jason, Freddy, and Michael Myers. These frivolous fears do not […]

Different Ways of Working Tailor Mayzent for Early SPMS Patients, Novartis Says

The effectiveness of Mayzent (siponimod) in both the brain and the body make it an oral therapy tailored for people with early secondary progressive multiple sclerosis (SPMS), according to Dan Bar-Zohar, MD, top executive with Novartis, the treatment’s developer. Mayzent was recently approved by the U.S. Food and Drug Administration (FDA) for adults with relapsing forms of multiple sclerosis […]

#AANAM – Ibudilast Slows Brain Atrophy in PPMS But Not SPMS Patients, Phase 2b Trial Shows

Treatment with oral ibudilast slows brain shrinkage in patients with primary progressive multiple sclerosis (PPMS), but not in those with secondary progressive MS (SPMS), according to results of a Phase 2b clinical trial. According to the findings, this could be partially due to faster disease progression in untreated controls with PPMS. The study, “Response to Treatment […]

Mayzent Joins the MS Medication Arsenal, But I Have Questions

As you might have heard, a disease-modifying therapy (DMT) for patients with active secondary progressive multiple sclerosis (SPMS) was approved a few days ago. That’s great news. A medication targeting SPMS is overdue, but it could be better. The DMT is Mayzent (siponimod), a tablet that’s taken once a day. The U.S. Food and Drug […]