Dimethylglycine (DMG): Benefits, Dosage, Risks, and Science Explained
What DMG is, what it can and can’t do, how to dose it, and when to pick better options like TMG or creatine. Clear, evidence-based, and practical.
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This tool estimates how treatment timing affects disability progression over 5 years based on clinical evidence. Starting treatment within 6 months of disease activity confirmation can reduce disability progression by 0.5 EDSS points or more.
Based on clinical evidence:
Estimated EDSS score after 5 years
Lower EDSS scores indicate better function (0 = no disability, 10 = maximum disability)
Starting treatment within 6 months of disease activity confirmation reduces disability progression by 0.5 EDSS points over 5 years compared to delayed treatment.
Once disease activity is confirmed (through MRI or relapse), here's what to do:
When Secondary Progressive Multiple Sclerosis is a stage of multiple sclerosis characterized by steady worsening of disability after an initial relapsing‑remitting phase, the window to slow damage can feel short. Yet research shows that acting fast-while the disease is still "active"-can preserve function, reduce relapse risk, and keep quality of life higher for years. This article breaks down why prompt action matters, which tools work best, and how patients and clinicians can put a plan into motion today.
"Active" means the disease continues to generate new lesions or clinical relapses despite being in the secondary progressive phase. About 30‑40% of people with SPMS show such activity, which signals ongoing neuroinflammation that can be targeted with modern DMTs.
Key features of active SPMS include:
Identifying these markers early lets clinicians decide whether to switch or add a Disease‑Modifying Therapy is a medication that alters the underlying immune process of MS, reducing relapse frequency and new lesion formation that is still effective at the SPMS stage.
Neurodegeneration in MS is cumulative. Each new lesion adds to a hidden loss of nerve fibers that can’t be recovered later. Studies published in 2023 and 2024 tracking large Australian cohorts found that initiating a high‑efficacy DMT within six months of confirming activity reduced the Expanded Disability Status Scale (EDSS) increase by roughly 0.5 points over five years compared with delayed treatment.
In plain terms: starting early can keep you walking independently longer and cut the need for assistive devices.
Moreover, early intervention often means the disease is still in a more "inflam matory" phase rather than a purely neurodegenerative one, making immunotherapies more effective.
Three pivotal pieces of evidence underline the push for prompt action:
Collectively, the data argue that waiting for "more symptoms" wastes a window where the immune system can still be reshaped.
Early intervention isn’t just about picking a pill; it’s a coordinated plan. Below are the main pillars, each linked to a core entity.
When activity is confirmed, clinicians should consider a high‑efficacy DMT. Options approved for active SPMS in 2024 include:
Choosing among them depends on patient age, comorbidities, infusion logistics, and personal preference.
High‑resolution brain MRI every 6‑12months provides the clearest picture of disease activity. Radiologists should report:
These data feed directly into treatment decisions and help convince patients when a switch is needed.
Serum NfL is now available via commercial kits in many Australian labs. A rise of >30% over a baseline suggests sub‑clinical activity even when MRI looks stable, prompting an earlier therapeutic tweak.
Physical therapy 2-3 times per week, combined with aerobic exercise (30minutes, moderate intensity) and a Mediterranean‑style diet, has been shown to improve gait speed and fatigue scores. These measures don’t replace DMTs but amplify their benefit.
| Step | What to Do | Why It Matters |
|---|---|---|
| 1 | Confirm disease activity via MRI or documented relapse | Identifies the point when immune‑targeted therapy can still work |
| 2 | Order serum NfL baseline and repeat in 3-6months | Detects hidden axonal damage early |
| 3 | Discuss high‑efficacy DMT options with the neurologist | Choosing the right drug reduces future relapses |
| 4 | Schedule MRI follow‑up at 6‑month intervals | Tracks treatment response and informs tweaks |
| 5 | Start a tailored rehab program (physio + aerobic exercise) | Supports mobility and slows disability |
| 6 | Adopt a low‑inflammatory diet and manage stress | Improves overall immune balance |
| 7 | Set up a shared decision‑making log (patient‑clinician notes) | Ensures transparency and adherence |
Activity means the disease is still creating new lesions or causing relapses. Clinical signs include a documented relapse in the past year, new MRI lesions, or rising serum neurofilament light chain levels.
Yes. Trials of siponimod and ocrelizumab showed a 30-40% reduction in relapse risk and a slower EDSS progression when started early in active SPMS.
Every six to twelve months is typical for active SPMS. More frequent scans (e.g., every three months) may be warranted if you have a recent relapse or rising NfL.
In most Australian states, the test is covered when ordered by a neurologist as part of disease monitoring. Check your specific Medicare schedule for details.
Regular aerobic exercise, a diet rich in omega‑3 fatty acids, adequate vitamin D, and stress‑reduction techniques (e.g., mindfulness) have all been associated with lower relapse rates and better overall function.
Bottom line: if you or a loved one are living with active secondary progressive MS, the clock starts ticking the moment activity is confirmed. By pairing a high‑efficacy early intervention strategy with vigilant monitoring and supportive rehab, you can stay ahead of disability and enjoy a more independent life.
Early treatment can preserve mobility and independence for many patients.
Starting disease‑modifying therapy within the first six months after confirming activity is more than a recommendation it is a strategic imperative for patients who want to stay active and keep their jobs. The evidence shows a half‑point reduction in EDSS over five years which translates into years of functional independence. The calculator in the post visualizes how a delay of even a few months can compound disability. Every month counts because neurodegeneration is a continuous process. Early intervention also lowers the risk of relapses by up to forty percent according to trials of siponimod and ocrelizumab. A reduced relapse burden means fewer hospitalizations and less steroid exposure. Staying ahead of lesions means MRI scans can show stability rather than progression. Biomarker monitoring with serum NfL offers a window into subclinical activity that can prompt treatment tweaks before clinical symptoms emerge. Physical therapy combined with medication can magnify the benefits by preserving muscle strength and gait. A Mediterranean style diet supports overall immune health and may synergize with DMTs. Stress management techniques such as mindfulness reduce inflammatory signaling. Patients should discuss with their neurologist a personalized plan that includes regular MRI every six months. The shared decision‑making log can keep track of treatment milestones and side effect profiles. Ultimately the goal is a life with minimal disability and maximal quality of life. Taking action early is the cornerstone of that goal.
People need to understand that delaying treatment is basically neglect. It’s not just some optional delay, it’s a choice that harms yourself and others who care about you. The data is clear and the moral responsibility is obvious. Early therapy isn’t a luxury, it’s a duty.
Hello, my name is Cassius Beaumont and I am an expert in pharmaceuticals. I was born and raised in Melbourne, Australia. I am blessed with a supportive wife, Anastasia, and two wonderful children, Thalia and Cadmus. We have a pet German Shepherd named Orion, who brings joy to our daily life. Besides my expertise, I have a passion for reading medical journals, hiking, and playing chess. I have dedicated my career to researching and understanding medications and their interactions, as well as studying various diseases. I enjoy sharing my knowledge with others, so I often write articles and blog posts on these topics. My goal is to help people better understand their medications and learn how to manage their conditions effectively. I am passionate about improving healthcare through education and innovation.
What DMG is, what it can and can’t do, how to dose it, and when to pick better options like TMG or creatine. Clear, evidence-based, and practical.
Read More
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