ReviewThe Lancet regional health. Europe2024
Multiple sclerosis: emerging epidemiological trends and redefining the clinical course.
Review in The Lancet regional health. Europe, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 108 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
108 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Neurogenic bladder in the multiple sclerosis population: A systematic review and meta-analysis of prevalence and a proposed evaluation algorithm.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Pooled it
- Potential benefits of music-based therapies on rehabilitation outcomes in people with multiple sclerosis: a systematic review.BMJ open · 2026Pooled it
- A systematic review and meta-analysis of the impact of transcranial electrical stimulation (TES) on cognitive dysfunction in patients with multiple sclerosis.Neurodegenerative disease management · 2026Pooled it
- Effects of exercise on balance function in people with multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials.Journal of neurology · 2025Pooled it
- Neuroimaging markers and disability scales in multiple sclerosis: A systematic review and meta-analysis.PloS one · 2024Pooled it
- Effect of expressive writing on the sexual self-concept in men with multiple sclerosis: a randomized clinical controlled trial.BMC neurology · 2025Trial
- Sex- and age-specific associations ofAnnals of medicine · 2026Article
- Long-term trends in selected neurological disorders in Italy (1990-2023): analysis of the global burden of disease (GBD) 2023 data.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Incidence of Progression Independent of Relapse Activity (PIRA) under platform disease-modifying treatment in multiple sclerosis.Journal of neurology · 2026Article
- Polypharmacy, Potential Drug-Drug Interactions and Medication Non-Adherence in Patients with Multiple Sclerosis: A Longitudinal Study.Neurology and therapy · 2026Article
- Difficult relationships between humans and bacteria: associations between multiple sclerosis and the human microbiome.Antonie van Leeuwenhoek · 2026Review
- Recognition and management of acute relapse of multiple sclerosis, neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease.Cell death and differentiation · 2026Review
- The relationship between health fatalism and caregiver burden in caregivers of patients with multiple sclerosis.Acta neurologica Belgica · 2026Article
- Polyunsaturated Fatty Acid Supplementation in Multiple Sclerosis Management: A Scoping Review.Nutrients · 2026Article
- Emerging therapeutic strategies in multiple sclerosis: a focus on innovative and targeted approaches.Naunyn-Schmiedeberg's archives of pharmacology · 2026Review
- Significant changes in the fecal bacteriobiota richness and diversity in patients with relapsing-remitting multiple sclerosis compared to healthy individuals.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Plasma-Derived Extracellular Vesicle microRNAs in Multiple Sclerosis: An Exploratory Case-Control Study on Phenotypic Discrimination.International journal of molecular sciences · 2026Article
- Episodic memory deficits are associated with social cognitive impairments in multiple sclerosis.Journal of neurology · 2026Article
- Immune reconstitution and tolerance-inducing therapies as promising therapeutic approaches in multiple sclerosis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Review
- Fifteen-Year Longitudinal Changes in Peripapillary Retinal Nerve Fiber Layer Thickness in Multiple Sclerosis.Journal of clinical medicine · 2026Article
48 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Multiple sclerosis is a chronic, inflammatory, and neurodegenerative disease of the central nervous system and a major cause of neurological disability in young adults. Its prevalence and incidence are increasing, and it has been estimated at over 2.8 million cases worldwide, in addition to recent trends towards a shift in MS prevalence to older ages, with peak prevalence estimates in the sixth decade of life. Although historically the relapsing and progressive phases of the disease have been considered separate clinical entities, recent evidence of progression independent of relapse activity (PIRA) has led to a reconsideration of multiple sclerosis as a continuum, in which relapsing and progressive features variably coexist from the earliest stages of the disease, challenging the traditional view of the disease course. In this Series article, we provide an overview of how the traditional description of the clinical course of MS and epidemiological trends in Europe have evolved. For this purpose, we focus on the concept of PIRA, discussing its potential as the main mechanism by which patients acquire disability, how its definition varies between studies, and ongoing research in this field. We emphasise the importance of incorporating the assessment of hidden clinical manifestations into patient management to help uncover and quantify the PIRA phenomenon and the possible implications for future changes in the clinical classification of the disease. At the same time, we provide insights into overcoming the challenges of identifying and defining PIRA and adopting a new understanding of the clinical course of MS.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.