Once you switch over from relapsing-remitting multiple sclerosis RRMS to secondary progressive multiple sclerosis (SPMS), you may need to adjust your treatment plan. There are four types of SPMS-active, active-progressing, non-active progressing and stable. Each one gets a different treatment style.

ACTIVE SPMS – When you have active SPMS, it means that you still have relapses-periods of time when your symptoms flare up-just like when you had the relapsing-remitting form of the disease.

If that is the case, you may still take disease-modifying drugs (DMDs), like you did for RRMS. DMDs can help prevent relapses and make the ones you do get less severe.

DMDs that treat SPMS include:

Lemtrada, Mavenclad, Vumerity, Tecfidera,Copaxone,Gilenya, Avonex, Beta Seron, Rebif, Novantrone, Tysabri, Ocrevus,Kesimpta, Zeposia, Ponvory, Mayzent, Aubagio,Briumvi

You can continue to take the one you took when you had RRNS, if that helps you.

Corticoid steroid drugs are another option. They bring down the inflammation in your brain and spinal cord to make your relapses shorter and less severe.

ACTIVE-PROGRESSING SPMS – In this type, you have relapses and your symptoms gradually get worse. You may need stronger treatment.

Maybe a different DMD or the chemotherapy drug mitoxantrone. It works by stopping the attack by the immune system on the protective coating around your nerve cells (myelin).

NON-ACTIVE PROGRESSING SPMS –

You’ll usually take steroids for short periods of time because they can cause side effects like upset stomach, fast heartbeat, flushing of the face, mood swings, chest pain and weak bones if you take them for long.

In this type of SPMS, you don’t have relapses but your symptoms get worse.

If this is your situation, you can try a rehabilitation program to improve your strength and help you move. A rehabilitation program can include: Physical Therapy, including exercises to improve flexibility, balance, strength, energy level and pain. Occupational Therapy, to help you manage your daily activities more easily. You’ll learn to: Conserve energy,use tools to help you do daily tasks and organize your work area to make it easier to get things done. Cognitive rehabilitation, exercises to improve your memory, attention and other thinking skills. Speech-language therapy, used to teach you how to speak more clearly and easily and how to eat without choking.

STABLE SPMS – If your symptoms aren’t getting worse, your doctor may recommend treatments to help manage them and keep you moving and drugs to treat problems like pain,depression,trouble sleeping, frequent urination.