biostudies-literatureUnknown145(9)Lublin FDNovartis Pharma AGPatients with multiple sclerosis acquire disability either through relapse-associated worsening (RAW) or progression independent of relapse activity (PIRA). This study addresses the relative contribution of relapses to disability worsening over the course of the disease, how early progression begins and the extent to which multiple sclerosis therapies delay disability accumulation. Using the Novartis-Oxford multiple sclerosis (NO.MS) data pool spanning all multiple sclerosis phenotypes and paediatric multiple sclerosis, we evaluated ∼200 000 Expanded Disability Status Scale (EDSS) transitions from >27 000 patients with ≤15 years follow-up. We analysed three datasets: (i) A full analysis dataset containing all observational and randomized controlled clinical trials in which disability and rBrain : a journal of neurology3147-3161https://www.ebi.ac.uk/biostudies/studies/S-EPMC9536294biostudies-literatureHow patients with multiple sclerosis acquire disability.PMC9536294Ocampo ACuklina JWiendl HArnold DLLublin FDNichols TEHatami FKieseier BCBermel RAAarden PDahlke FGanjgahi HHaring DAChitnis TfalseHow patients with multiple sclerosis acquire disability.Patients with multiple sclerosis acquire disability either through relapse-associated worsening (RAW) or progression independent of relapse activity (PIRA). This study addresses the relative contribution of relapses to disability worsening over the course of the disease, how early progression begins and the extent to which multiple sclerosis therapies delay disability accumulation. Using the Novartis-Oxford multiple sclerosis (NO.MS) data pool spanning all multiple sclerosis phenotypes and paediatric multiple sclerosis, we evaluated ∼200 000 Expanded Disability Status Scale (EDSS) transitions from >27 000 patients with ≤15 years follow-up. We analysed three datasets: (i) A full analysis dataset containing all observational and randomized controlled clinical trials in which disability and r2022-01-01T00:00:00Z2022 Sep2025-04-18T21:00:53.144Z2025-04-07T09:01:17.045ZS-EPMC95362943510484010.1093/brain/awac016