Modifying the Disease Course
One medication -- Ocrevus™ (ocrelizumab) -- has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of primary-progressive MS (PPMS) as well as for relapsing forms of MS. The other approved disease-modifying therapies have all been shown to be effective in relapsing forms of MS, which include primary and secondary progressive MS in those individuals who experience a relapse or evidence of disease activity on MRI. The disease-modifying therapies work primarily by reducing inflammation in the central nervous system (CNS); they do not work as well in a disease course that is characterized by nerve degeneration rather than inflammation. For this reason, they have not been shown to be effective in progressive forms of the disease unless a person demonstrates relapses or MRI activity caused by inflammation.
Several of these agents, including Copaxone® and an experimental drug called Rituxan, have been studied in PPMS, but unfortunately without a positive effect on progression. There are several clinical trials either recently completed or ongoing for progressive forms of MS and some are for PPMS. Read more about clinical trials in MS.
In addition to treatment with a disease-modifying therapy, there are other symptom management and rehabilitation strategies that people with PPMS and their healthcare teams can use to manage the disease.