Is best managed by emerging therapies like Tolebrutinib ( not yet available), that shows promise in trials by targeting inflammation. Traditional disease modifying. Therapies are largely ineffective for inactive SPMS. Managing lifestyle factors-specifically regular exercise, smoking recession, and a healthy diet- can help manage disability progression and improve quality of life. I also search for and consume natural anti-inflammatories, like fatty fish, berries, leafy greens, turmeric and ginger.