Year: 2026
Type: review
Abstract: People with multiple sclerosis (pwMS) often experience disability progression even when receiving disease-modifying therapies that effectively suppress relapses. This phenomenon is commonly referred to as progression independent of relapse activity (PIRA). Currently, it is challenging to characterize pwMS who are experiencing disability progression in clinical practice. Existing definitions of PIRA rely primarily on the Expanded Disability Status Scale (EDSS), which is biased towards ambulation and does not effectively capture the gradual accumulation of symptoms and signs across other clinical areas associated with disability progression. Here, we propose a step-by-step approach that neurologists can use in clinical practice to identify pwMS experiencing disability progression irrespective of age, EDSS, or disease duration. By using this approach, neurologists can assess the presence or absence of specific variables to help determine if disability is stable or progressing. This could enable appropriate treatments to be implemented in a timely manner, particularly as new disability-targeting therapies become available.
Source: Journal of Neurology
Institutions: Hasselt University, Universidad Complutense de Madrid, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, University of Copenhagen, Copenhagen University Hospital, Rigshospitalet, Danish Multiple Sclerosis Center, University of Turku, Turku University Hospital, University of Bern, University Hospital of Bern, Innsbruck Medical University, Universität Innsbruck, Aristotle University of Thessaloniki, The University of Sydney, Heinrich Heine University Düsseldorf, Palacký University Olomouc, University of Ferrara, Inserm, Université de Lille, Centre Hospitalier Universitaire de Lille, Lille Neurosciences & Cognition, University Hospital Carl Gustav Carus, Centre for Tactile Internet with Human-in-the-Loop, Technische Universität Dresden, Univerzitetski Klinički Centar Srbije, Alfaisal University, King Faisal Specialist Hospital & Research Centre, Ain Shams University, Sapienza University of Rome
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,790
OpenAlex ID: W7225182628