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Article History

Received: 8 May 2025

Revised: 11 August 2025

Accepted: 12 August 2025

First Online: 4 September 2025

Declarations

:

: D.E. had no personal financial interests to disclose other than being an employee of the GMSR. N.F. is an employee of the GMSR. Moreover, he is an employee of Rostock’s University Medical Center and received travel funds for research meetings from Novartis. None resulted in a conflict of interest. A.S. has no personal pecuniary interests to disclose, other than being the lead of the German MS Registry, which receives (project) funding from a range of public and corporate sponsors, recently including The German Innovation Fund (G-BA), The German Retirement Insurance, The German MS Trust, The German MS Society, Bristol Myers Squibb, Merck Healthcare Germany GmbH, Novartis Pharma GmbH, Roche Pharma AG and TG Therapeutics/Neuraxpharm. None resulted in a conflict of interest. C.W. has received institutional support from Novartis, Alexion, Sanofi Genzyme, Biogen, Merck, and Roche. None resulted in a conflict of interest. K.H. has received speaking fees and/or institutional grant support from Bayer, Biogen, BMS, Merck Serono, Novartis, Roche, Sanofi-Genzyme, and Teva. None resulted in a conflict of interest. D.K. has nothing to disclose. C.K. has received speaker’s fees, honoraria for attending advisory boards, and financial support for conducting research projects from Merck Serono GmbH Germany, and Merck KgaA Germany. None resulted in a conflict of interest. P.F. has received speaker’s fees and honoraria for advisory boards from Almirall, Bayer, Biogen Idec, BMS-Celgene, Coloplast, Genzyme, GW Pharma, Hexal, Janssen-Cilag, Novartis, Merck, Roche, Sanofi, Stadapharm, and Teva. None resulted in a conflict of interest. M.M. is an employee of the German MS Society, federal association, which receives funding from a range of public and corporate sponsors, recently including BMG, G-BA, The German MS Trust, Biogen, BMS, Merck Serono, Novartis, Roche, Sanofi, and Viatris. None resulted in a conflict of interest. M.G. received honoraria and travel reimbursements for attending meetings from Biogen, Celgene, Merck Serono, Novartis, Roche, Sanofi Genzyme, and TEVA. His research is funded by the German Ministry for Education and Research (BMBF), Deutsche Forschungsgemeinschaft (DFG), Merck Serono, and Novartis. None resulted in a conflict of interest. U.K.Z. has received speaking fees, travel support and /or financial support for research activities from Alexion, Almirall, Bayer, Biogen, Bristol Myers Squibb, Janssen, Merck Serono, Novartis, Octapharma, Roche, Sanofi Genzyme, Teva as well as EU, BMBF, BMWi, and DFG. None resulted in a conflict of interest.

: The registration of the GMSR took place at the German Registry for Clinical Trials [Deutsches Register Klinischer Studien (DRKS); No. DRKS00011257]. The initial ethics vote was approved by University of Würzburg’s institutional review board (Permit No. 142/12). All participants provided written consent for the utilization of their anonymized data for research purposes.