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Article History

Received: 27 August 2025

Accepted: 29 January 2026

First Online: 12 February 2026

Declarations

:

: The authors report no conflicts of interest with respect to the contents of the current study, but note that the patients in the study were treated with a number of disease-modifying drugs and that authors have received advisory board, membership, speakers honoraria, travel support, research grants, consulting fees, or clinical trial support from the manufacturers of those drugs, including Actelion, Allergan, Almirall, Alexion, Bayer Schering, Biogen, Bristol-Myers Squibb, Celgene, Excemed, Genzyme, Forward Pharma, Ipsen, Medday, Merck, Mylan, Novartis, Sanofi, Roche, Teva, and their local affiliates.

: Data about the cohort considered in the study were collected from the database of the Italian Multiple Sclerosis Register (RISM), of which our centre is a part. RISM was approved by the ethical committee at the “Azienda Ospedaliera/Universitaria—Policlinico of Bari” (Study REGISTRO SM001, approved on 08/07/2016). Patients signed an informed consent that allows to use clinical data for research purposes.