{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:35:28Z","timestamp":1777937728071,"version":"3.51.4"},"reference-count":10,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T00:00:00Z","timestamp":1677456000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["301728"],"award-info":[{"award-number":["301728"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["EAN\/ACA-006\/7488627\/C"],"award-info":[{"award-number":["EAN\/ACA-006\/7488627\/C"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001782","name":"University of Melbourne","doi-asserted-by":"publisher","award":["Dentistry and Health Sciences research fellowship"],"award-info":[{"award-number":["Dentistry and Health Sciences research fellowship"]}],"id":[{"id":"10.13039\/501100001782","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1080518"],"award-info":[{"award-number":["1080518"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1083539"],"award-info":[{"award-number":["1083539"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1129189"],"award-info":[{"award-number":["1129189"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1140766"],"award-info":[{"award-number":["1140766"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The prognostic significance of non-disabling relapses in people with relapsing-remitting multiple sclerosis (RRMS) is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine whether early non-disabling relapses predict disability accumulation in RRMS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We redefined mild relapses in MSBase as \u2018non-disabling\u2019, and moderate or severe relapses as \u2018disabling\u2019. We used mixed-effects Cox models to compare 90-day confirmed disability accumulation events in people with exclusively non-disabling relapses within 2\u2009years of RRMS diagnosis to those with no early relapses; and any early disabling relapses. Analyses were stratified by disease-modifying therapy (DMT) efficacy during follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>People who experienced non-disabling relapses within 2\u2009years of RRMS diagnosis accumulated more disability than those with no early relapses if they were untreated ( n\u2009=\u2009285 vs 4717; hazard ratio (HR)\u2009=\u20091.29, 95% confidence interval (CI)\u2009=\u20091.00\u20131.68) or given platform DMTs ( n\u2009=\u20091074 vs 7262; HR\u2009=\u20091.33, 95% CI\u2009=\u20091.15\u20131.54), but not if given high-efficacy DMTs ( n\u2009=\u2009572 vs 3534; HR\u2009=\u20090.90, 95% CI\u2009=\u20090.71\u20131.13) during follow-up. Differences in disability accumulation between those with early non-disabling relapses and those with early disabling relapses were not confirmed statistically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study suggests that early non-disabling relapses are associated with a higher risk of disability accumulation than no early relapses in RRMS. This risk may be mitigated by high-efficacy DMTs. Therefore, non-disabling relapses should be considered when making treatment decisions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585231151951","type":"journal-article","created":{"date-parts":[[2023,3,5]],"date-time":"2023-03-05T01:52:20Z","timestamp":1677981140000},"page":"875-883","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Early non-disabling relapses are important predictors of disability accumulation in people with relapsing-remitting multiple sclerosis"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2329-5329","authenticated-orcid":false,"given":"Cyrus","family":"Daruwalla","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5511-509X","authenticated-orcid":false,"given":"Vahid","family":"Shaygannejad","sequence":"additional","affiliation":[{"name":"Isfahan University of Medical Sciences, Isfahan, Iran"}]},{"given":"Serkan","family":"Ozakbas","sequence":"additional","affiliation":[{"name":"Dokuz Eylul University, Izmir, Turkey"}]},{"given":"Eva Kubala","family":"Havrdova","sequence":"additional","affiliation":[{"name":"Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1915-0036","authenticated-orcid":false,"given":"Dana","family":"Horakova","sequence":"additional","affiliation":[{"name":"Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5436-5804","authenticated-orcid":false,"given":"Raed","family":"Alroughani","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait"}]},{"given":"Cavit","family":"Boz","sequence":"additional","affiliation":[{"name":"KTU Medical Faculty Farabi Hospital, Trabzon, Turkey"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6923-0846","authenticated-orcid":false,"given":"Francesco","family":"Patti","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies, GF Ingrassia, Catania, Italy Multiple Sclerosis Center, University of Catania, Catania, Italy"}]},{"given":"Marco","family":"Onofrj","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Imaging and Clinical Sciences, University G. D\u2019Annunzio, Chieti, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2902-5589","authenticated-orcid":false,"given":"Alessandra","family":"Lugaresi","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche e Neuromotorie, Universit\u00e0 di Bologna, Bologna, Italy IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9159-3128","authenticated-orcid":false,"given":"Sara","family":"Eichau","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen Macarena, Sevilla, Spain"}]},{"given":"Marc","family":"Girard","sequence":"additional","affiliation":[{"name":"CHUM and Universite de Montreal, Montreal, QC, Canada"}]},{"given":"Alexandre","family":"Prat","sequence":"additional","affiliation":[{"name":"CHUM and Universite de Montreal, Montreal, QC, Canada"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7231-1754","authenticated-orcid":false,"given":"Pierre","family":"Duquette","sequence":"additional","affiliation":[{"name":"CHUM and Universite de Montreal, Montreal, QC, Canada"}]},{"given":"Bassem","family":"Yamout","sequence":"additional","affiliation":[{"name":"Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon"}]},{"given":"Samia J","family":"Khoury","sequence":"additional","affiliation":[{"name":"Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6704-9787","authenticated-orcid":false,"given":"Seyed Aidin","family":"Sajedi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neuroscience Research Center, Golestan University of Medical Sciences, Gorgan, Iran"}]},{"given":"Recai","family":"Turkoglu","sequence":"additional","affiliation":[{"name":"Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey"}]},{"given":"Ayse","family":"Altintas","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine and Koc University Research Center for Translational Medicine (KUTTAM), Koc University, Istanbul, Turkey"}]},{"given":"Olga","family":"Skibina","sequence":"additional","affiliation":[{"name":"Department of Neurology, Box Hill Hospital, Melbourne, VIC, Australia Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia"}]},{"given":"Katherine","family":"Buzzard","sequence":"additional","affiliation":[{"name":"Department of Neurology, Box Hill Hospital, Melbourne, VIC, Australia Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia MS Centre, Royal Melbourne Hospital, Melbourne, VIC, Australia"}]},{"given":"Pierre","family":"Grammond","sequence":"additional","affiliation":[{"name":"CISSS Chaudi\u00e8re-Appalache, Levis, QC, Canada"}]},{"given":"Rana","family":"Karabudak","sequence":"additional","affiliation":[{"name":"Hacettepe University, Ankara, Turkey"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4278-7003","authenticated-orcid":false,"given":"Anneke","family":"van der Walt","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia"}]},{"given":"Helmut","family":"Butzkueven","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia"}]},{"given":"Davide","family":"Maimone","sequence":"additional","affiliation":[{"name":"Centro Sclerosi Multipla, UOC Neurologia, ARNAS Garibaldi, Catania, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3850-447X","authenticated-orcid":false,"given":"Jeannette","family":"Lechner-Scott","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health, University Newcastle, Newcastle, NSW, Australia Department of Neurology, John Hunter Hospital, Hunter New England Health, Newcastle, NSW, Australia"}]},{"given":"Aysun","family":"Soysal","sequence":"additional","affiliation":[{"name":"Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey"}]},{"given":"Nevin","family":"John","sequence":"additional","affiliation":[{"name":"Monash Medical Centre, Melbourne, VIC, Australia Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia"}]},{"given":"Julie","family":"Prevost","sequence":"additional","affiliation":[{"name":"CSSS Saint-J\u00e9r\u00f4me, Saint-Jerome, QC, Canada"}]},{"given":"Daniele","family":"Spitaleri","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino, Avellino, Italy"}]},{"given":"Cristina","family":"Ramo-Tello","sequence":"additional","affiliation":[{"name":"Hospital Germans Trias i Pujol, Badalona, Spain"}]},{"given":"Oliver","family":"Gerlach","sequence":"additional","affiliation":[{"name":"Academic MS Center Zuyderland, Department of Neurology, Zuyderland Medical Center, Sittard-Geleen, The Netherlands School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands"}]},{"given":"Gerardo","family":"Iuliano","sequence":"additional","affiliation":[{"name":"Ospedali Riuniti di Salerno, Salerno, Italy"}]},{"given":"Matteo","family":"Foschi","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Neurology Unit, S. Maria delle Croci Hospital of Ravenna, AUSL Romagna, Ravenna, Italy"}]},{"given":"Radek","family":"Ampapa","sequence":"additional","affiliation":[{"name":"Nemocnice Jihlava, Jihlava, Czech Republic"}]},{"given":"Vincent","family":"van Pesch","sequence":"additional","affiliation":[{"name":"Cliniques Universitaires Saint-Luc, Brussels, Belgium Universit\u00e9 Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2156-8864","authenticated-orcid":false,"given":"Michael","family":"Barnett","sequence":"additional","affiliation":[{"name":"Brain and Mind Centre, Sydney, NSW, Australia"}]},{"given":"Nevin","family":"Shalaby","sequence":"additional","affiliation":[{"name":"Neurology, Kasr Al Ainy MS Research Unit (KAMSU), Cairo, Egypt"}]},{"given":"Marie","family":"D\u2019hooghe","sequence":"additional","affiliation":[{"name":"Department of Neurology, National MS Center, Melsbroek, Belgium"}]},{"given":"Jens","family":"Kuhle","sequence":"additional","affiliation":[{"name":"Neurology, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Departments of Head, Spine and Neuromedicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland"}]},{"given":"Maria Jose","family":"Sa","sequence":"additional","affiliation":[{"name":"Department of Neurology, Centro Hospitalar Universitario de Sao Joao, Porto, Portugal Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal"}]},{"given":"Marzena","family":"Fabis-Pedrini","sequence":"additional","affiliation":[{"name":"Perron Institute for Neurological and Translational Science, University of Western Australia, Nedlands, WA, Australia Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, WA, Australia"}]},{"given":"Allan","family":"Kermode","sequence":"additional","affiliation":[{"name":"Perron Institute for Neurological and Translational Science, University of Western Australia, Nedlands, WA, Australia Institute of Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia Sir Charles Gairdner Hospital, Nedlands, WA, Australia"}]},{"given":"Saloua","family":"Mrabet","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Razi \u2013 Manouba, Tunis, Tunisia Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia"}]},{"given":"Riadh","family":"Gouider","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Razi \u2013 Manouba, Tunis, Tunisia"}]},{"given":"Suzanne","family":"Hodgkinson","sequence":"additional","affiliation":[{"name":"Immune Tolerance Laboratory, Ingham Institute and Department of Medicine, University of New South Wales (UNSW), Sydney, NSW, Australia"}]},{"given":"Guy","family":"Laureys","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Ghent, Ghent, Belgium"}]},{"given":"Liesbeth","family":"Van Hijfte","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Ghent, Ghent, Belgium"}]},{"given":"Richard","family":"Macdonell","sequence":"additional","affiliation":[{"name":"Austin Health, Melbourne, VIC, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9221-5716","authenticated-orcid":false,"given":"Celia","family":"Oreja-Guevara","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Clinico San Carlos, Madrid, Spain"}]},{"given":"Edgardo","family":"Cristiano","sequence":"additional","affiliation":[{"name":"Centro de Esclerosis M\u00faltiple de Buenos Aires (CEMBA), Buenos Aires, Argentina"}]},{"given":"Pamela","family":"McCombe","sequence":"additional","affiliation":[{"name":"The University of Queensland, Brisbane, QLD, Australia Royal Brisbane and Women\u2019s Hospital, Herston, QLD, Australia"}]},{"given":"Jose Luis","family":"Sanchez-Menoyo","sequence":"additional","affiliation":[{"name":"Hospital de Galdakao-Usansolo, Galdakao, Spain"}]},{"given":"Bhim","family":"Singhal","sequence":"additional","affiliation":[{"name":"Bombay Hospital Institute of Medical Sciences, Mumbai, India"}]},{"given":"Yolanda","family":"Blanco","sequence":"additional","affiliation":[{"name":"Center of Neuroimmunology, Service of Neurology, Hospital Clinic de Barcelona, Barcelona, Spain"}]},{"given":"Stella","family":"Hughes","sequence":"additional","affiliation":[{"name":"Royal Victoria Hospital, Belfast, UK"}]},{"given":"Justin","family":"Garber","sequence":"additional","affiliation":[{"name":"Westmead Hospital, Sydney, NSW, Australia"}]},{"given":"Claudio","family":"Solaro","sequence":"additional","affiliation":[{"name":"Department of Neurology, ASL3 Genovese, Genova, Italy Department of Rehabilitation, M.L. Novarese Hospital, Moncrivello, Italy"}]},{"given":"Chris","family":"McGuigan","sequence":"additional","affiliation":[{"name":"St. Vincent\u2019s University Hospital, Dublin, Ireland"}]},{"given":"Bruce","family":"Taylor","sequence":"additional","affiliation":[{"name":"Royal Hobart Hospital, Hobart, TAS, Australia"}]},{"given":"Koen","family":"de Gans","sequence":"additional","affiliation":[{"name":"Groene Hart Ziekenhuis, Gouda, The Netherlands"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3360-1748","authenticated-orcid":false,"given":"Mario","family":"Habek","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Center Zagreb, Zagreb, Croatia University of Zagreb, School of Medicine, Zagreb, Croatia"}]},{"given":"Abdullah","family":"Al-Asmi","sequence":"additional","affiliation":[{"name":"College of Medicine & Health Sciences and Sultan Qaboos University Hospital, Sultan Qaboos University, Seeb, Oman"}]},{"given":"Simu","family":"Mihaela","sequence":"additional","affiliation":[{"name":"Department of Neurology, Victor Babes University of Medicine and Pharmacy, Timi\u0219oara, Romania"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9249-3185","authenticated-orcid":false,"given":"Tamara","family":"Castillo Trivi\u00f1o","sequence":"additional","affiliation":[{"name":"Hospital Universitario Donostia and IIS Biodonostia, San Sebasti\u00e1n, Spain"}]},{"given":"Talal","family":"Al-Harbi","sequence":"additional","affiliation":[{"name":"Neurology Department, King Fahad Specialist Hospital-Dammam, Khobar, Saudi Arabia"}]},{"given":"Juan Ignacio","family":"Rojas","sequence":"additional","affiliation":[{"name":"Hospital Universitario de CEMIC, Buenos Aires, Argentina"}]},{"given":"Orla","family":"Gray","sequence":"additional","affiliation":[{"name":"South Eastern HSC Trust, Belfast, UK"}]},{"given":"Dheeraj","family":"Khurana","sequence":"additional","affiliation":[{"name":"Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India"}]},{"given":"Bart","family":"Van Wijmeersch","sequence":"additional","affiliation":[{"name":"University MS Centre, Hasselt-Pelt, Belgium Noorderhart Rehabilitation & MS Center, Pelt and Hasselt University, Hasselt, Belgium"}]},{"given":"Nikolaos","family":"Grigoriadis","sequence":"additional","affiliation":[{"name":"AHEPA University Hospital, Thessaloniki, Greece"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5892-751X","authenticated-orcid":false,"given":"Jihad","family":"Inshasi","sequence":"additional","affiliation":[{"name":"Rashid Hospital, Dubai, United Arab Emirates"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5519-6088","authenticated-orcid":false,"given":"Jiwon","family":"Oh","sequence":"additional","affiliation":[{"name":"St. Michael\u2019s Hospital, Toronto, ON, Canada"}]},{"given":"Eduardo","family":"Aguera-Morales","sequence":"additional","affiliation":[{"name":"University Hospital Reina Sofia, Cordoba, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8726-089X","authenticated-orcid":false,"given":"Yara","family":"Fragoso","sequence":"additional","affiliation":[{"name":"Universidade Metropolitana de Santos, Santos, Brazil"}]},{"given":"Fraser","family":"Moore","sequence":"additional","affiliation":[{"name":"Jewish General Hospital, Montreal, QC, Canada"}]},{"given":"Cameron","family":"Shaw","sequence":"additional","affiliation":[{"name":"Geelong Hospital, Geelong, VIC, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8138-7504","authenticated-orcid":false,"given":"Seyed Mohammad","family":"Baghbanian","sequence":"additional","affiliation":[{"name":"Booali Sina Hospital, Neurology Department, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran"}]},{"given":"Neil","family":"Shuey","sequence":"additional","affiliation":[{"name":"St. Vincent\u2019s Hospital, Fitzroy, Melbourne, VIC, Australia"}]},{"given":"Barbara","family":"Willekens","sequence":"additional","affiliation":[{"name":"Department of Neurology, Antwerp University Hospital, Edegem, Belgium Translational Neurosciences Research Group, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4145-3172","authenticated-orcid":false,"given":"Todd A","family":"Hardy","sequence":"additional","affiliation":[{"name":"Concord Repatriation General Hospital, Sydney, NSW, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7689-3114","authenticated-orcid":false,"given":"Danny","family":"Decoo","sequence":"additional","affiliation":[{"name":"AZ Alma Ziekenhuis, Damme, Belgium"}]},{"given":"Angel Perez","family":"sempere","sequence":"additional","affiliation":[{"name":"Hospital General Universitario de Alicante, Alicante, Spain"}]},{"given":"Deborah","family":"Field","sequence":"additional","affiliation":[{"name":"Lyell McEwin Hospital, Elizabeth Vale, SA, Australia"}]},{"given":"Ray","family":"Wynford-Thomas","sequence":"additional","affiliation":[{"name":"Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK Helen Durham Centre for Neuroinflammation, University Hospital of Wales, Cardiff, UK"}]},{"given":"Nick G","family":"Cunniffe","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0371-3666","authenticated-orcid":false,"given":"Izanne","family":"Roos","sequence":"additional","affiliation":[{"name":"MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia CORe, Department of Medicine, University of Melbourne, Melbourne, VIC, Australia"}]},{"given":"Charles B","family":"Malpas","sequence":"additional","affiliation":[{"name":"MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia CORe, Department of Medicine, University of Melbourne, Melbourne, VIC, Australia Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia"}]},{"given":"Alasdair J","family":"Coles","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3778-1376","authenticated-orcid":false,"given":"Tomas","family":"Kalincik","sequence":"additional","affiliation":[{"name":"MS Centre, Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia CORe, Department of Medicine, University of Melbourne, Melbourne, VIC, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7737-5834","authenticated-orcid":false,"given":"J William L","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK"}]}],"member":"179","published-online":{"date-parts":[[2023,2,27]]},"reference":[{"key":"bibr1-13524585231151951","unstructured":"European Medicines Agency (EMA). Tysabri, https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/tysabri (2018, accessed 16 March 2022)."},{"key":"bibr2-13524585231151951","unstructured":"European Medicines Agency (EMA). Gilenya, https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/gilenya (2018, accessed 15 March 2022)."},{"key":"bibr3-13524585231151951","doi-asserted-by":"publisher","DOI":"10.1177\/1352458512450091"},{"key":"bibr4-13524585231151951","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30067-3"},{"key":"bibr5-13524585231151951","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2018.4905"},{"key":"bibr6-13524585231151951","unstructured":"NHS England. Treatment algorithm for multiple sclerosis disease-modifying therapies, 2018, https:\/\/www.england.nhs.uk\/commissioning\/wp-content\/uploads\/sites\/12\/2019\/03\/Treatment-Algorithm-for-Multiple-Sclerosis-Disease-Modifying-Therapies-08-03-2019-1.pdf"},{"key":"bibr7-13524585231151951","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/67.1.145"},{"key":"bibr8-13524585231151951","doi-asserted-by":"publisher","DOI":"10.1177\/1352458514528762"},{"key":"bibr9-13524585231151951","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000342458.39625.91"},{"key":"bibr10-13524585231151951","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24682"}],"container-title":["Multiple Sclerosis Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585231151951","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13524585231151951","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585231151951","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:11:27Z","timestamp":1777695087000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13524585231151951"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,27]]},"references-count":10,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1177\/13524585231151951"],"URL":"https:\/\/doi.org\/10.1177\/13524585231151951","relation":{},"ISSN":["1352-4585","1477-0970"],"issn-type":[{"value":"1352-4585","type":"print"},{"value":"1477-0970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,27]]}}}