A recent study by Lublin et al. (https://pubmed.ncbi.nlm.nih.gov/35104840/) showed that disability accrual independent from disease relapse starts early in multiple sclerosis, occurs in all phenotypes and becomes the principal driver of disability accumulation in the progressive phase of the disease. Disease modifying treatments hardly prevent relapse-independent worsening even though they delay the time to milestones disability, suggesting the presence of underlying ongoing inflammatory and/or degenerative mechanism secondary to disease burden.
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