Since approximately 50% of MS patient will “progress” (What a misnomer..) from Relapsing Remitting Multiple Sclerosis (RRMS)  to Secondary Progressive Multiple Sclerosis (SPMS), most MS patients should pay attention to news on the topic of SPMS.

You will notice that such news are rather scarce, because the understanding and the battery of Disease Modifying Treatments is vastly superior to that of SPMS.

So we welcome Medscape’s post [1] on the topic of Secondary Progressive management. Particularly conforting is the statement of Dr Schapiro

“…Almost all patients with progressive MS stop progressing at some point. Obviously, we would like to stop the progression earlier rather than later, but without treatment, progression usually still halts at some point. It is rare to die from MS, but rather, people die with MS…”

Then, Dr Schapiro proceeds to recommend the following management tools:

  • Regular physical and occupational therapy.
  • Speech therapy may be necessary for swallowing, speech, and cognition.
  • A properly fitting, independently powered wheelchair is essential to maintaining mobility in disability.
We posted on emerging therapies for SSPMS [2], namely stem cells therapies. The hope, as in all stem cell therapy, is based on regeneration mechanisms that the stem cells initiate. Diseased tissue would make way for healthy one.
This research has up and downs, see [2]
Even though RRMS often evolves into SPMS, many see the two stages seem very different. RRMS being mostly inflammatory and SPMS neurodegenerative. See [3] for a discussion on the two modes. Note that [3] contends that inflammation persists in SPMS, and even Primary Progressive MS.
“…Our study suggests a close association between inflammation and neurodegeneration in all lesions and disease stages of multiple sclerosis..”
If it were true, shouldn’t the RRMS drugs should have more success on SPMS?

Sources:

  1. Medscape Neurology ; “Secondary Progressive Multiple Sclerosis Management” ; Randall T. Schapiro ; 2009
  2. MediNewsDigest ; “Progress in Stem Cell Treatment of Secondary Progressive Multiple Sclerosis” ; 2012
  3. Brain ; “The relation between inflammation and neurodegeneration in multiple sclerosis brains” ; 2009

 

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