Treatment for SPMS?
Q
I am paralyzed in my legs and my left arm. Is there any treatment for secondary progressive MS?
A
The interferons, Rebif and Betaseron, have been shown to have an effect on attacks in secondary progressive MS. There is conflicting data on their effects on gradual progression, but many neurologists feel that there is at best a modest effect on gradual progression, and probably mainly in the early stages of progressive disease.
Mitoxantrone, which is a chemotherapy, has been shown to help when frequent attacks and progression are both occurring, but this treatment has the potential for many side effects, and is limited to a maximum of 3 years at current doses. Most would recommend this for fairly aggressive disease, only. Another chemotherapy, methotrexate, showed modest benefits in an earlier study, but only for a limited number of outcome measures. Experimental approaches abound. Antegren and stem cell approaches are two with particular promise.
In many cases, when gradual progression has been occurring for a long time and there is considerable permanent disability, many neurologists would not recommend treatment apart from symptomatic measures. Physiotherapy and exercise can also lead to modest gains and help to maintain your present abilities.
Dr. J. E. Paulseth
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