Marc Girard, 29 Alexandre Prat, 29 Jose Luis Sanchez-8 Menoyo, 30,31 Vincent van Pesch, 32,33 Aysun Soysal, 34,35 Maria Pia Amato
(2026) (2026)
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- 21 Clinically silent MRI lesions occur frequently in people with relapsing-remitting multiple 22 sclerosis (RRMS) despite disease modifying therapy (DMT). Guidelines only routinely 23 recommend DMT escalation after multiple silent lesions, and adherence is variable. We 24 explored outcomes and the effect of treatment escalation following single and multiple on-25 treatment silent lesions. 26 This cohort study and emulated target trial used MSBase registry data from 99 clinics in 26 27 countries between 2007 and 2025. Clinically stable participants receiving any DMT for 28 RRMS with silent lesions versus without silent lesions were compared. Among participants 29 with silent lesions while taking platform or moderate-efficacy DMTs, outcomes following 30 treatment escalation within 6 months versus no treatment escalation (unless a post-MRI 31
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Daruwalla, C., Kremler, C., Patti, F., Ozakbas, S., Boz, C., Lechner-Scott, J., Surcinelli, A., Foschi, M., Khoury, S., Butzkueven, H., Van Der Walt, A., Rous, Z., Habek, M., Gross-Paju, K., Kuhle, J., Castillo-TriviƱo, T., Kerrigan, S., 16 Tolkovsky, A., et al. (2026). Marc Girard, 29 Alexandre Prat, 29 Jose Luis Sanchez-8 Menoyo, 30,31 Vincent van Pesch, 32,33 Aysun Soysal, 34,35 Maria Pia Amato. Submitted. https://doi.org/10.1093/brain/awag252/8741305 (Original work published 2026)