Maryam,   I am sorry I didn't get back to you sooner - somehow I didn't see the email!  Mike is pretty stable and is still on the methotrexate.  He is also going on ampyra (which is the same as 4-AP - which he will discontinue).  He is working full time, his gait remains about the same and he is not really complaining about fatigue too much - in fact, I think he has more energy than I do at times!  I hope that this is helpful to you - I know how discouraging everything about PPMS is - it was terrible to read but I am very grateful for the help of Dr. Sadiq and is staff - he runs an amazing practice and I always feel hopeful when I leave there.  I hope that your husband is doing well-it's certainly not an easy road.   Paula