ORIGINAL RESEARCH article
Front. Neurol.
Sec. Multiple Sclerosis and Neuroimmunology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1595929
Progression independent of relapsing biology in multiple sclerosis: a real-word study
Provisionally accepted
- 1Alberta Health Services, Calgary, Canada
- 2Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Progression independent of relapse activity (PIRA) implies disability progression in people with relapsing-remitting multiple sclerosis (RRMS) secondary to neurodegeneration. Mechanistically and biologically PIRA could impact the traditional distinction between progressive and relapsing-MS. Herein, we estimated progression independent of relapsing biology (PIRB) in a cohort of 823 participants with clinically-isolated syndrome/RRMS in Calgary, Canada using a modified criterion [excluding relapses, inflammatory MRI activity, interim disability worsening/improvement over the observation period, and progression secondary to alternative causes including formal conversion to secondary-progressive MS]. PIRB was rare and rates remained consistent across disease-modifying therapies (3.75% dimethyl fumarate, 3.67% fingolimod, 3.72% ocrelizumab, 3.52% minocycline) despite varied rates of disability progression.PIRB may offer a practical alternative to the concept of PIRA.
Keywords: progression independent of relapse biology, progression independent of relapse activity, PIRA, Multiple Sclerosis, MS, Relapsing Remitting Multiple Sclerosis, clinically isolated syndrome, Real-world
Received: 18 Mar 2025; Accepted: 06 May 2025.
Copyright: © 2025 Yong and Camara-Lemarroy. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Carlos Rodrigo Camara-Lemarroy, Alberta Health Services, Calgary, Canada
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.