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Medically reviewed and verified by Kate Burke, MD, MHA
When facing a diagnosis of nrSPMS, one of the most common questions patients and caregivers have is what are our options for treatment? nrSPMS is a chronic disease that affects the central nervous system. While nrSPMS has no cure, there are treatments available to slow the progression of the disease.
For nrSPMS, doctors will recommend a combination of medication and lifestyle adjustments to treat the disease. Here is a breakdown from PatientsLikeMe on the therapy options, how they work, and potential side effects.
Disease-Modifying Therapies (DMTs)
Disease-modifying therapies (DMTs) are drugs used to slow down the progression of nrSPMS. DMTs work by slowing progression and reducing long-term nerve damage rather than preventing relapses." However, some DMTs may also help reduce the number and severity of relapses in some of the other categories of MS. While DMTs are not a cure for MS, they help limit the long-term damage the disease causes to the nervous system.
The evidence based treatment guidelines for nrSPMS in 2025 include the use of FDA approved DMTs such as:
- Siponimod
- Mitoxantrone
- Interferon beta-1
Siponimod is a sphingosine 1-phosphate receptor modulator specifically approved for active forms of SPMS, including non-relapsing forms. Mitoxantrone is a chemotherapeutic agent approved for worsening RRMS and SPMS. It has been shown to reduce the risk of disability progression in SPMS, although its use islimited by potential severe side effects, including cardiotoxicity and secondary malignancies.
Interferon beta-1b (Betaseron, Extavia): Interferon beta-1b is approved for SPMS and has demonstrated efficacy in reducing the risk of relapse and slowing disability progression.
Symptom Management
Medication is not the only way to treat nrSPMS! Because the condition affects movement, cognition, and energy levels, other therapies can help with daily life. Physical therapy is commonly used to strengthen muscles, improve balance, and help with mobility. Occupational therapy teaches techniques for accomplishing daily tasks. While the name suggests it is supposed to help people with their jobs, occupational therapy is just geared around whatever your life asks of you. So, any barrier you might have to getting dressed or eating, occupational therapy will teach you techniques to overcome them.
Many people with progressive MS have issues with speech and with swallowing. Voice, speech and swallowing therapists can help people regain function. Cognitive therapy helps with memory, problem-solving, and focus. All of these require someone to stick to a regular routine! Progress is made through consistency and dedication.
Experimental and Alternative Therapies for treating nrSPMS
Beyond the FDA approved medications, researchers are always looking into new treatments for conditions like nrSPMS. Some experimental therapies have shown promise, but their effectiveness is still being studied. Autologous Hematopoietic Stem Cell Transplantation (AHSCT) aims to reset the immune system and has shown the most benefit in aggressive RRMS, though its role in nrSPMS remains uncertain. Bruton’s Tyrosine Kinase Inhibitors (BTKIs) are being tested in clinical trials for MS and work by blocking immune signals that cause inflammation and nerve damage.
High-dose biotin was once thought to promote myelin repair, but recent clinical trials have not confirmed significant benefits in progressive MS. Antioxidants may help combat oxidative stress, which is linked to neurodegeneration, but there is no strong clinical evidence that they slow MS progression. Because no single therapy works for everyone, it is essential to discuss treatment options with a doctor. Ongoing research may lead to new, more effective therapies for managing nrSPMS.
Treating nrSPMS takes a combination of disease-modifying therapies and symptom management. No single therapy works for everyone. You should talk about your options with your doctor to find the best approach. There is also ongoing research and new and more effective treatments that may become available in the future. These can help to improve the quality of life.
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