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What Are “Active” and “Inactive” Multiple Sclerosis?

Active, progressive, relapsing? Your doctor may talk to you about these terms, but what do they all mean for you? Multiple sclerosis (MS) affects each person in different ways. However, experts have found certain patterns in how the disease tends to progress.

Types of MS

About 80 to 85 percent of people with MS are first diagnosed with relapsing-remitting MS (RRMS). With this type of MS, people experience symptom flare-ups, also called relapses. This may happen if a pre-existing symptom gets worse, or it can be a new symptom that develops. The relapse can last anywhere from a few days to a few months. After the relapse, the person may be symptom-free for long periods of time before they have another relapse.1

Over time, some people with RRMS may transition to secondary-progressive MS (SPMS). In people with SPMS, the disease is starting to slowly and steadily progress and worsen. About half of those with RRMS develop SPMS within 10 years of diagnosis.

Active vs. inactive MS

If a person with SPMS is still experiencing relapses, this is called “active” SPMS. Generally, a person with active SPMS will have fewer relapses than someone with RRMS. If there are no more relapses, this is classified as “inactive” or “non-active” SPMS.1

About 10 to 15 percent of people are initially diagnosed with another type of MS called primary-progressive MS (PPMS). With this type, there is steady progression and worsening from the beginning. Those with PPMS are also further categorized as active, experiencing relapses; or inactive, not experiencing relapses.1,2

Why is it important to know what type of MS I have?

The type of MS you have helps you and your doctor decide which type of treatment is best for you.

Most MS medications are approved by the U.S. Food and Drug Administration (FDA) for the relapsing forms of MS, including RRMS and active SPMS. These treatments are called disease-modifying therapies (DMTs). They are used to decrease how often relapses happen and lessen how badly they affect the person with MS. Research has shown that DMTs have been successful in slowing or delaying the progression of MS. DMTs can be injectable, oral, or infusion medicines.3

Treatment for inactive SPMS and other progressive forms of MS

More research is needed to find effective treatments for the progressive types of MS, including inactive SPMS. One FDA-approved treatment option is mitoxantrone. Mitoxantrone is an intravenous (IV) infusion medication indicated to reduce neurologic disability.3 However, there are some risks that should be discussed with your doctor. Ongoing research into treatments for inactive SPMS and other progressive forms include stem cell therapy, high dose biotin, lipoic acid, and anti-inflammatories, among others.4

Strategies to improve or maintain function and mobility, as well as symptom management and emotional wellbeing, are also key parts of a well-rounded MS treatment plan, regardless of the type of MS.

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