Continued advancements in treatment and care are improving outcomes for people with MS.

Multiple sclerosis (MS) develops when your immune system mistakenly attacks myelin, the protective coating that surrounds nerves in your central nervous system.

MS is classified according to its progression over time. Secondary progressive MS (SPMS) typically develops some time after a diagnosis of relapsing-remitting MS (RRMS). RRMS features clearly defined periods of active neurological symptoms (relapses) and periods of full or partial recovery (remission).

Progressive forms of MS are marked by a progression of disability without the periods of remission that occur in RRMS. Some people have primary progressive MS, in which they experience progressively worsening symptoms early in the disease course. SPMS is a progressive form of the disease that begins after several years of RRMS.

Most people with RRMS will develop SPMS later in life. SPMS involves a gradual, steady increase in neurological symptoms and difficulty functioning. SPMS can have a relapsing-remitting pattern, or it can be non-remitting with persistent symptoms.

Because progressive forms of MS, such as SPMS, lead to increased disability over time, they are often associated with lower quality of life and an increase in complications that may affect life span.

Life expectancy vs. mortality rate vs. prognosis in MS

Life expectancy is the average length of time that people are expected to live.

Mortality rate is the number of deaths from a particular cause (such as MS) in a given time frame.

Prognosis (outlook) is the likely outcome or course of a disease.

Most people with MS are thought to have an average life expectancy. However, MS-related complications can affect mortality rate. And the prognosis for MS is highly individualized based on a variety of personal factors.

Thanks to advances in treatment and care, most people with MS have a typical life expectancy.

This means that if you have an MS diagnosis, you’re generally expected to live just as long as people who don’t have the disease.

However, mortality rates among people with MS appear to be higher than in the larger population. Mortality rates are different from life expectancy. They represent the calculated number of deaths among a population (people with MS) over a set amount of time.

According to a nationally representative study from 2022, MS is associated with an 80% increased risk of mortality among adults in the United States.

If the life expectancy is similar, why is the mortality rate higher?

Differences between life expectancy and mortality rate in MS are often attributed to complications that can affect overall well-being and reduce the chances of survival.

MS, in all its forms, affects people differently. The outcomes are significantly influenced by many factors, including:

  • the course of the disease
  • any comorbidities (co-occurring conditions)
  • complications, such as loss of mobility
  • lack of access to treatment
  • lifestyle habits

Common complications and comorbidities in MS that can affect life span include:

  • cardiovascular disease
  • respiratory disease
  • urinary tract conditions
  • depression and anxiety
  • diabetes
  • obesity
  • frequent infections
  • sleep issues

Progressive forms of MS are associated with more significant disability and more severe symptoms. They’re also more likely than other forms of MS to result in complications that affect life span.

How quickly RRMS transitions to SPMS is another factor that can influence your life span.

Not everyone with RRMS will go on to develop SPMS. But if you develop SPMS earlier than average, you might experience complications sooner.

One large-scale, global study from 2023 found that RRMS progressed to SPMS in a median time of 10 years. This means that in half of participants who developed SPMS, the progression occurred within 10 years of their RRMS diagnosis, while in the other half, the progression occurred after they had lived with RRMS for 10 years.

MS isn’t usually fatal on its own, and the outlook varies from person to person.

Your outlook will depend on individual considerations such as your overall health, the severity of the disease, any risk factors you have, and how your condition responds to treatment.

Factors associated with a favorable outlook in MS include:

  • having a relapsing course
  • having mild relapses
  • experiencing near-complete or complete recovery during remission
  • having a long period of symptom remission between your first and second relapses
  • experiencing mainly sensory-related symptoms (like the “MS hug”)
  • having few MS lesions visible on MRI scans
  • being female
  • having optic neuritis, which can lead to an earlier diagnosis

Factors associated with a less favorable MS outlook include:

  • having a progressive course
  • having frequent relapses
  • experiencing minimal recovery during remission
  • experiencing symptoms that affect several abilities (such as vision and movement)
  • experiencing mainly symptoms that affect muscle control, balance, coordination, or fine motor skills
  • having a large number of MS lesions and brain atrophy that are visible on MRI scans
  • being male

SPMS is managed with a multidisciplinary approach. Your healthcare team will consist of a variety of specialists who can help address your individual needs, such as:

  • a neurologist
  • a primary care doctor
  • a physical therapist
  • an occupational therapist
  • a speech therapist
  • a urologist
  • a psychologist

These specialists will work together to create a comprehensive treatment plan to address the symptoms and progression of SPMS and possible complications such as functional impairment, increased infection rates, and mental health challenges.

The Food and Drug Administration (FDA) has approved more than 20 disease-modifying therapies (DMTs) for use in relapsing forms of MS, including SPMS. DMT options include medications you can take by mouth, medications you can inject at home, and medications you can receive as infusions at an MS treatment center or clinic.

In December 2024, the drug tolebrutinib received the FDA’s “breakthrough therapy” designation for use in non-remitting SPMS. No DMTs have yet been approved to treat SPMS in a non-remitting pattern. A breakthrough therapy designation from the FDA helps streamline the approval process for promising new treatments.

Tolebrutinib is one of several Bruton’s tyrosine kinase (BTK) enzyme inhibitors being tested for use in MS.

SPMS affects an estimated 27 to 45 of every 100,000 people in the United States. So if you have SPMS, you’re not alone. Resources are available to connect you with others who live with SPMS as well as professionals who are knowledgeable in treating the disease.

You can find support groups in your area or online by visiting the National Multiple Sclerosis Society’s community search page. To find MS specialists in your area, check out the Society’s doctors and resources search page.

You can also learn more about SPMS online through the MS International Federation and the Multiple Sclerosis Association of America.

SPMS is a progressive form of MS that may develop after you’ve lived with RRMS for some time. While the life expectancy for people with MS is generally similar to that of the broader population, mortality rates are higher in people who have MS than in those who do not.

Even though the life expectancy is typical, the outlook for SPMS can differ significantly from person to person, depending on variables such as disease course, personal risk factors, lifestyle habits, and response to treatment. For some people with progressive forms of MS, such as SPMS, complications and co-occurring conditions can reduce life span.

If you have SPMS, you can work with your healthcare team to determine your individual outlook and the best ways to treat and manage the disease.