Secondary Progressive MS (SPMS)
Secondary progressive MS (SPMS) is a stage of MS which comes after relapsing remitting MS in many cases. Neurologists generally agree secondary progressive MS is a "sustained build up of disability, independent of any relapses".
Most people with relapsing remitting MS will eventually develop secondary progressive MS. It varies widely from person to person, but on average, around 65 per cent of people with relapsing remitting MS will develop secondary progressive MS 15 years after being diagnosed.
It can be hard to diagnose. Most neurologists will look for at least six months of clear progression before they use the term secondary progressive.
It is possible to be diagnosed with this type of MS when you are first diagnosed with the condition - if the relapsing remitting phase of MS had never been identified - but this is rare.
It's different from primary progressive MS, which is progressive from the beginning.
What sort of changes might happen?
In MS, two things can lead to a build up of disability:
- incomplete recovery from relapses
- a gradual progression of the condition.
Secondary progressive MS is characterised by a worsening of disability, rather than by relapses followed by recovery. Some people may experience relapses (relapsing secondary progressive MS), but people with secondary progressive MS don't tend to recover completely from a relapse.
You might have noticed more difficulties with getting around than before, or other symptoms might have become worse. Changes can happen very slowly though, so it might take some time before you and your doctor are sure you have secondary progressive MS.
Everyone's MS is different - even if someone else has secondary progressive MS, they're likely to be affected in an individual way.
Some people will continue to have relapses with secondary progressive MS. If you do, it can make it harder to work out whether your MS is relapsing remitting or secondary progressive.
If you do have relapses, recovery can take some time. It can be hard to tell whether symptoms are due to progression (therefore may remain) or the lingering effect of a relapse (and will go).
Managing secondary progressive MS
You might also consider:
If you have secondary progressive MS with relapses, then these can be treated with steroids. Find out more about managing relapses.
Disease modifying therapies
Guidelines produced by the Association of British Neurologists say that the disease modifying therapy beta interferon should be available for people with secondary progressive MS if they are still having relapses, and if it is clear these relapses are the main cause of increasing disability.
If you think this may be the case, ask your neurologist, MS nurse, GP or the MS Society Information Team for more details.
Research has shown that mitoxantrone, a strong drug that suppresses the immune system, may also be effective in treating secondary progressive MS, particularly for those who have relapses. It appears to be much less effective for those who do not still have relapses.