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Gupta 2014
In SPMS, characterized by steady deterioration without acute attacks, treatment strategies often involve continuing or altering DMT used during the earlier RRMS phase, such as interferon beta, or considering immune-modulating agents, such as methotrexate, cyclophosphamide, or glucocorticoid pulses [142, 143]
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It offers the largest surface area of accessible subcutaneous fat, it is easy to see and reach, and most people find it the least painful option
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