Then talk to your Dr. about switching, your MS might be not B-cell driven at all but more T-cell driven like mine. Suggest something that sequesters or modulates the immune system by T-cells. I'm on oral Mayzent and am stable after progressing to SPMS in 2022, I wasn't on anything when transitioned.

Yes,I agree with Dr Dale, call your neurologist

Thank you. You explained this to me in layman’s terms so I understand everything you said. I also made an appt with my dr. Again thank you. Very informative.

Hi @A MyMSTeam Member, it is how they work in your body. Kesimpta targets and kills the B-cells in your immune system. Many of the earlier drugs were targeted to either suppressing T-cells or sequestering them in the thymus so they weren't circulating and able to get into the CNS.
The only way to know if your MS is driven by one type of cells or another is to be observant what medications work for you as there is no test yet to determine this. I have almost 35 years of observation on myself which is how I determined alot about my disease, however I'm the first to say what works for me might not work for others.
If your not responding well to a therapy that kills the B-cells and getting worse, its likely your B-cells are not the main driver of your MS. The S1PR modulators (Gilenya, Ozanaomod and posinimod) prevent T-cells from exiting the thymus, circulating and getting into the CNS.
Other drugs either suppress the T-cell response or prevent T-cells from entering the CNS, Examples of these are Copaxone, Tysarbi and others.
There are almost 20 meds out there for MS, find one that works for you, you can tolerate and has a manner of administration that you will take constantly, there are orals, injectables, and infused drugs all with different mechanisms of actions.

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A MyMSTea...

The biggest thing is how do you feel? Please don't let others decide ,as so many "others" think the medication is a fix/cure and well we know different .
SPMS is secondary , and tends to herald a gradual decline rather than the randomness of RRMS (but alot of current meds like Ocrevus can help that as well). Most people start as RRMS (relapsing remitting) and often develops into Secondary progressive.