It is unfortunate that we feel the need to classify our MS as either or when in all cases it is most likely both. I have seen SPMS patients have exacerbations (relapses) and I have been progressing as an RRMS patient. What separates a bad week from a relapse? Most likely not mechanism but only scale. So if your relapses are too small to be seen by your Nuero you must be SPMS?
I don't think so, but I'm sure the insurance companies do. If copaxone is doing its job (lowering relapse rate) and the patient is still progressing - does that mean they no longer need copaxone? That's a load of hogwash - but the insurance companies will surely note that glatrimar isn't FDA approved for SPMS. Ok, no worries, this patient will soon be able to take biotin (MD1003). Until they have a relapse and realize that SPMS and RRMS are not either or but both and.
Which is why I am taking copaxone AND biotin (10 mg 20x daily with sunflower seeds)