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One is less common, but way more noticeable: if you have a single HDD, especially a SATA2 or worse one, then when something tries to read and write at the same time, the system slows down to a crawl. So there is a possibility that something is trying to read quite large save files that are automatically created. Usually an antivirus does that.
The other is the more common issue. The game is not optimised for multi-core, it uses mainly the first core, plus does some additional computing on the second. The problem is that lots of mods using NVSE bog down the main core. Since you have the Stutter Remover, you can go to its INI file and enable heap replacement to balance the load a little better. The TXT file next to the INI will guide you through it. (I should also mention that on some systems the heap replacer can cause massive instability in the game leading to severe memory management errors.)
Also, for anyone with an interest - I de-activated CASM from my game and it worked in a way, it did reduce the spikes but not by much, but atleast they don't last as long now
Try heap replacement with the Stutter Remover. It's more than likely that you will get frequent crashes, but if not, that will help with your problem quite a lot.