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Patients with RRMS who are untreated or ineffectively treated can go on to develop secondary progressive multiple sclerosis (SPMS) after many years. SPMS is characterized by a very gradual worsening of symptoms in between sudden attacks. Although a number of neurologic symptoms can slowly progress, many patients describe a gradual worsening of strength in their legs, muscle stiffness, and changes in their bladder function. Over time, the progression becomes more prominent and relapses may stop completely. SPMS is characterized by less inflammation and fewer changes on MRI’s than RRMS. For this reason, many of our anti-inflammatory treatments are not as effective in this group.
There are, however, a number of experimental treatment options that have shown promise. The physicians at the IMSMP, together with the scientists at the Tisch MS Research Center, have explored a number of experimental treatments for SPMS, including the use of intrathecal methotrexate, Rituximab, and plasmapheresis. Patients with SPMS tend to have more overall symptoms than relapsing patients and benefit from an MS center that addresses a multitude of issues. The physicians at the IMSMP pay special attention to a variety of symptoms that significantly impact patients’ daily lives, including bowel, bladder and sexual function, fatigue, cognition, pain, and spasticity.