As an active secondary progressive disease patient, managing stress is crucial for maintaining our overall health and well-being. High stress levels can exacerbate symptoms and hinder our ability to cope with the disease. By incorporating stress management techniques into our daily routine, we can improve our mental and emotional state, leading to a better quality of life. This includes practices such as mindfulness meditation, regular exercise, and maintaining a strong support system. In summary, prioritizing stress management is essential for active secondary progressive disease patients to enhance our resilience and overall health.
Active Secondary Progressive Disease (active SPMS) — quick, practical guide
Active secondary progressive disease (often called active SPMS) is a phase of multiple sclerosis where disability steadily increases and there’s evidence of ongoing inflammatory activity. That activity shows up as new relapses or new lesions on MRI. If you or someone you care for is getting worse and still having relapses or MRI changes, this page explains what to expect and what to ask your team.
How doctors define "active" and how it’s diagnosed
“Active” usually means one of two things: recent clinical relapses, or new/enlarging lesions on brain or spinal cord MRI (sometimes with contrast enhancement). Neurologists will combine your history, a neurological exam, and MRI results. They often track disability with an EDSS score and repeat MRIs every 6–12 months if needed. Blood tests and other checks rule out infections, vitamin deficiencies, or other causes that can mimic progression.
Treatment options and what to expect
Treatment aims to slow inflammation that still appears active, manage symptoms, and keep you functioning. For active SPMS there are disease-modifying therapies (DMTs) approved or commonly used. Siponimod (Mayzent) is specifically approved for active SPMS in many countries; it can reduce relapses and slow disability progression in people with inflammatory activity. Before starting siponimod, you’ll likely need a simple genetic test (CYP2C9) and regular bloodwork to check lymphocyte counts and liver function. Tell your neurologist about heart issues—some meds need initial monitoring.
Older treatments such as interferons or mitoxantrone were used in progressive forms of MS in the past, but they have limits and side effects. B-cell therapies and other immune drugs are being studied for progressive MS; ask your neurologist whether any could fit your situation or clinical trials you might join.
Symptom care is as important as DMTs. Physical therapy keeps mobility and balance better. Spasticity often responds to baclofen, tizanidine, or local botulinum toxin injections. For fatigue, strategies include lifestyle changes, energy management, and sometimes medications like amantadine. Bladder issues, pain, and mood changes all have specific, practical treatments—don’t accept they’re untreatable.
Simple lifestyle steps help too: stay active within your limits, quit smoking, keep vitamin D in a recommended range, control blood pressure and weight, and treat sleep problems. Keep a clear record of relapses, new symptoms, and MRIs—this helps your neurologist pick the right plan.
If you think your disease is becoming active SPMS, see your neurologist and ask direct questions: Do my MRIs show new inflammation? Is a DMT like siponimod right for me? What monitoring will I need? Also ask about rehab, symptom meds, and clinical trials. Getting the right combination of drugs and rehab can slow decline and keep you living well.
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