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Article History

Received: 10 April 2026

Revised: 20 May 2026

Accepted: 22 May 2026

First Online: 2 June 2026

Declarations

:

: S.N. Hof: nothing to disclose. E. Keytsman: nothing to disclose. T.A. Fuchs received research support from the European Committee for Treatment and Research in Multiple Sclerosis, serves on the editorial board of Frontiers in Neurology, and received consulting fees for Click Therapeutics and Registry Multiple Sclerosis (ReMuS). M.H.J. Wessels: nothing to disclose. D. de Jong nothing to disclose. E.M.M. Strijbis: serves on the editorial board of Neurology and reports speaker fees from Merck and Novartis. M. Schoonheim: serves on the editorial board of Neurology, Multiple Sclerosis Journal and Frontiers in Neurology, receives research support from the Dutch MS Research Foundation, Eurostars-EUREKA, ARSEP, Amsterdam Neuroscience, MAGNIMS and has served as a consultant for or received research support from Atara Biotherapeutics, Biogen, Celgene/Bristol Meyers Squibb, EIP, Sanofi, MedDay and Merck. L.J. van Rijn: nothing to disclose. A. Petzold: reports Royalties/licenses for a chapter on INO from Up-to-Date. B.M.J. Uitdehaag: reports consultancy fees from Immunic Therapeutics. J. van Schependom: nothing to disclose. B.W. van Oosten: nothing to disclose.

: The study was approved by the Medical Ethical Committee on Human Research of the Amsterdam UMC (study number 2015.227), in accordance with the tenets of the Declaration of Helsinki.

: Informed consent was obtained from all individual participants included in the study.