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Article History

Received: 22 March 2026

Revised: 11 May 2026

Accepted: 13 May 2026

First Online: 22 May 2026

Declarations

:

: The authors declare no conflicts of interest related to the content of this study. They note, however, that patients included in the analysis received various disease-modifying therapies, and some authors have received honoraria, travel grants, consulting fees, research support, or participated in advisory boards sponsored by pharmaceutical companies, including Actelion, Allergan, Almirall, Alexion, Amgen, Bayer Schering, Biogen, Bristol Myers Squibb, Celgene, Excemed, Genzyme, Forward Pharma, Ipsen, Medday, Merck, Mylan, Novartis, Sanofi, Roche, Teva, and their affiliates. These relationships had no influence on the design, analysis, or interpretation of the study.

: The RMSR received ethical approval from the local ethical committee (Comitato Etico della Romagna—CEROM) on date 05/11/2021 (approval code: 3139). All participants gave written informed consent to be enrolled in the RMSR according to the Declaration of Helsinki, 1964.

: Not applicable.