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The Transition Between Relapsing-Remitting MS and Secondary Progressive MS

February 5, 2018

Multiple sclerosis patients can experience many difficulties when transitioning between relapsing-remitting MS (RRMS) and secondary-progressive MS (SPMS). With RRMS, some may experience an acute neurological event, and during SPMS, symptoms may progressively worsen. During this transition, people may still experience relapses while developing progressive symptoms.

While there are four different types or stages of MS, the most common course of the disease is RRMS, where the person undergoes attacks or relapses which are then followed by periods of remission where the symptoms reduce or disappear altogether. As each relapse occurs, symptoms tend to worsen or new ones appear, which then eventually progresses to the final stage, SPMS. This stage is characterized by periods of progression as well as increased disability.

During the transitioning period between these two stages, inflammation of the central nervous system occurs primarily through the gradual worsening of old injuries. Inflammation eventually affects the brain, spinal cord and optic nerve the most. Inflammation gives way to gradual degeneration as the disease progresses to SPMS, this overall affects the structural and functional integrity of nervous cells. The disability and progression of symptoms for the patient come at a faster pace than ever before at this time.

Fifty percent of those diagnosed with RRMS will transition to SPMS within 10 years of their first MS attack, according to the National Multiple Sclerosis Society. Around 90% of those would have made the transition by their 25th year of the onset of MS. This progress has been delayed by new medications.

While there is no cure for RRMS, treatments usually consist of managing the symptoms of the patient, so they can live a pain-free and independently functioning life. Steroids are used to treat the relapses that occur in those with SPMS.

There are therapies such as hemopietic stem cell transplantation (HSCT) used for those with MS. This therapy tries to stop the damage caused by MS and regrow the immune system in a healthy way using the patient’s stem cells.

Although, the most effective treatments are disease-modifying therapies, better known as DMTs. In this case, the medication helps reduce the severity of relapses and delay the progress of the disorder. This allows the transition from RRMS to SPMS to occur later rather than earlier.

There are other ways in which one could delay the progression of RRMS to SPMS as well, such as lifestyle changes the patient must make themselves. These lifestyle changes include a healthy diet, exercising regularly, getting enough sleep at night, and quitting alcohol and smoking along with any other addicting behaviors.