My neuro (He's head of the MS Research and Treatment Unit of the province in which I live), reclassified my MS as SP a couple of years ago and said that according to research, the DMDs have limited value in the treatment or management of SPMS. According to him, management of SPMS at this point is pretty much focused on symptom control, primarily of inflammation and spasticity, so that those affected can maintain function and use for as long and as much as possible.

He also said that the future looks brighter for people who are younger and newly diagnosed with RRMS because of ongoing research into DMDs and other interventions which may serve to prevent progression. He said that other research is focused upon regeneration of the myelin in demyelinating diseases like MS, as well as reprograming the immune systems of those with all forms of auto-immune disorders.

The main obstacle to seeing these research projects through?
As always, its $$$$$$$$$$$.

From my perspective, it does not only seem so, but has strongly been hinted at by those in the medical profession that I have received care from, that they are more often than not, at a loss as to how to help me or others with SPMS manage symptoms.
In the last couple of years I have had more drugs offered to me on a "trial basis" than in the decades before. I even had my PCP say that he would really like me to try prednisone for the joint inflammation. This, after it was realized that the joint inflammation is from an infection and that he is fully aware that my liver is highly reactive to steroids and is contraindicated.

I share this because I think that it is vitally important for those who have any disorder to be careful about taking anyone's suggestions or recommendations with respect to treatment, without analysing for themselves, on how those recommendations might be potentially positive or negative for their own circumstances.
Keeping track of symptoms (symptom journal), as well as reactions to medications and treatment, over a long period of time, is essential for being able to do that effectively.

With love, Erika