Dissecting definitions of disability accrual in relapsing multiple sclerosis-Have we reached standardization yet?

ABSTRACT:

Background

Distinguishing relapse-associated worsening (RAW) and progression independent of relapse activity (PIRA) has reshaped understanding of disability accumulation in relapsing multiple sclerosis (RMS). The influence of differing definitions of disability accrual on event rates and RAW/PIRA proportions remains uncertain.

Methods

This observational cohort study used Austrian MS Treatment Registry data (2010-2024). A custom algorithm evaluated 1440 definitional variants of disability accrual with varying confirmation duration, baseline modeling, and RAW/PIRA classification, including recently proposed "standardized" criteria.

Results

We included 3273 RMS patients (mean age 37.5 years; 67.8% female) with ⩾24 months follow-up, ⩾3 Expanded Disability Status Scale (ED

SUBMITTER: Bsteh G 

PROVIDER: S-EPMC12916871 | biostudies-literature | 2026 Feb

REPOSITORIES: biostudies-literature