Inactive SPMS presents a unique challenge in managing multiple sclerosis. Unlike the more familiar active SPMS, where relapses are evident, inactive SPMS progresses slowly, often with subtle worsening of symptoms that can be difficult to detect and treat. This gradual decline can affect daily life, and it’s currently a gap in MS treatment. However, while there aren’t medications specifically for this form of MS, there are approaches to manage symptoms and enhance quality of life.
Understanding Inactive SPMS and Treatment Options
The lack of specific medications targeting inactive SPMS highlights an area of ongoing research. Several drugs are undergoing clinical trials and being reviewed by the Food and Drug Administration (FDA), offering hope for future treatments aimed at slowing progression. In the meantime, symptom management and lifestyle adjustments play a vital role.
“While there isn’s any disease-specific therapy, we still want to make sure we’re treating your symptoms and doing everything we can to improve your quality of life,” explains Paunel Agyei, MD, a board-certified neurologist specializing in multiple sclerosis.
Your care team can work with you to tailor a plan that addresses your individual needs, encompassing medication, therapies, and lifestyle changes.
Medications to Address Symptoms
Although there are no drugs directly targeting inactive SPMS, certain medications can help manage the associated symptoms and potentially slow nervous system damage. These include:
- Disease-Modifying Therapies (DMTs): Your doctor might prescribe these to attempt to slow damage to the nervous system, even though they aren’t specific to inactive SPMS.
- Anticholinergic Drugs: Can help with urinary incontinence or urgency.
- Anticonvulsants: May reduce nerve pain and tingling.
- Antivirals: Might alleviate fatigue.
- Muscle Relaxants: Help ease muscle spasms and stiffness.
Complementary Therapies and Rehabilitation
Rehabilitation therapies are a crucial part of managing inactive SPMS. They won’t reverse damage, but they can improve daily function. A multidisciplinary approach, focusing on maintaining strength and function, is key. Consider the following:
- Physical Therapy: Aims to improve balance, gait, and strength.
- Cognitive Therapy: Focuses on improving the ability to focus, remember things, and think clearly.
- Occupational Therapy: Helps to make everyday activities, like brushing teeth or getting dressed, easier.
- Pelvic Floor Therapy: Improves bladder, bowel, and sexual function.
- Speech Therapy: Addresses communication or swallowing issues.
Lifestyle Strategies for Enhanced Well-being
Beyond medication and therapy, lifestyle adjustments can significantly impact how you feel and live with inactive SPMS.
- Mediterranean Diet: Linked to less objective disability in MS, this diet emphasizes fruits, vegetables, whole grains, and healthy fats.
- Restorative Sleep: Prioritizing quality sleep is essential.
- Stress Management: Techniques like yoga, meditation, or spending time in nature can help.
- Addressing Sleep Apnea: A systematic review suggests a significant connection between obstructive sleep apnea-hypopnea syndrome and MS.
- Acupuncture: Some studies indicate it may provide benefit for individuals with MS.
The Takeaway
Currently, there are no medications designed specifically to treat inactive SPMS. However, disease-modifying therapies can help manage symptoms like fatigue and muscle stiffness. Rehabilitation therapies, such as physical and occupational therapy, can ease daily tasks and enhance quality of life. Combined with a healthy lifestyle — including a Mediterranean diet, restorative sleep, and stress management — you can better manage your condition and maintain an improved quality of life.
Resources
- Clinical Trial: Intranasal Foralumab for Nonactive Secondary Progressive MS. National Multiple Sclerosis Society
- FDA Extends Its Review of Tolebrutinib for Non-Relapsing Secondary Progressive MS. National Multiple Sclerosis Society
- Multiple Sclerosis. Mayo Clinic
- Medications Used Off-Label. National Multiple Sclerosis Society
- Rehabilitation. National Multiple Sclerosis Society
Meet Our Experts
- Jason Paul Chua, MD, PhD, Medical Reviewer: Assistant Professor of Neurology at Johns Hopkins School of Medicine, specializing in neurodegenerative disease and autophagy.
- Abigail Libers, Author: Freelance writer focusing on health, nutrition, and lifestyle journalism.
