Data from expanded access programs and clinical trials evaluating intranasal foralumab in patients with non-active secondary progressive multiple sclerosis demonstrate promising therapeutic trends. Participants showed stabilization of clinical disability scores (EDSS), reductions in microglial activation measured via PET imaging, and clinically meaningful improvements in chronic fatigue. The treatments maintained an excellent safety profile without serious treatment-related adverse events, supporting progression to larger randomized, placebo-controlled trials.