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Wiendl H, Schmierer K, Hodgkinson S, Derfuss T, Chan A, Sellebjerg F, Achiron A, Montalban X, Prat A, De Stefano N, Barkhof F, Leocani L, Vermersch P, Chudecka A, Mwape C, Holmberg KH, Boschert U, Roy S. Specific Patterns of Immune Cell Dynamics May Explain the Early Onset and Prolonged Efficacy of Cladribine Tablets: A MAGNIFY-MS Substudy. Neurol Neuroimmunol Neuroinflamm 2022; 10:10/1/e200048. [PMID: 36411081 PMCID: PMC9679889 DOI: 10.1212/nxi.0000000000200048] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 09/06/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Cladribine tablets cause a reduction in lymphocytes with a predominant effect on B-cell and T-cell counts. The MAGNIFY-MS substudy reports the dynamic changes on multiple peripheral blood mononuclear cell (PBMC) subtypes and immunoglobulin (Ig) levels over 12 months after the first course of cladribine tablets in patients with highly active relapsing multiple sclerosis (MS). METHODS Immunophenotyping was performed at baseline (predose) and at the end of months 1, 2, 3, 6, and 12 after initiating treatment with cladribine tablets. Assessments included lymphocyte subtype counts of CD19+ B cells, CD4+ and CD8+ T cells, CD16+ natural killer cells, plasmablasts, and Igs. Immune cell subtypes were analyzed by flow cytometry, and serum IgG and IgM were analyzed by nephelometric assay. Absolute cell counts and percentage change from baseline were assessed. RESULTS The full analysis set included 57 patients. Rapid reductions in median CD19+, CD20+, memory, activated, and naive B-cell counts were detected, reaching nadir by month 2. Thereafter, total CD19+, CD20+, and naive B-cell counts subsequently reconstituted, but memory B cells remained reduced by 93%-87% for the remainder of the study. The decrease in plasmablasts was slower, reaching nadir at month 3. Decrease in T-cell subtypes was also slower and more moderate compared with B-cell subtypes, reaching nadir between months 3 and 6. IgG and IgM levels remained within the normal range over the 12-month study period. DISCUSSION Cladribine tablets induce a specific pattern of early and sustained PBMC subtype dynamics in the absence of relevant Ig changes: While total B cells were reduced dramatically, T cells were affected significantly less. Naive B cells recovered toward baseline, naive CD4 and CD8 T cells did not, and memory B cells remained reduced. The results help to explain the unique immune depletion and repopulation architecture regarding onset of action and durability of effects of cladribine tablets while largely maintaining immune competence. TRIAL REGISTRATION INFORMATION ClinicalTrials.gov Identifier: NCT03364036. Date registered: December 06, 2017.
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Affiliation(s)
- Heinz Wiendl
- From the Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany and Brain and Mind Center, University of Sydney, Australia; The Blizard Institute (K.S.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience) (K.S.), The Royal London Hospital, Barts Health NHS Trust, UK; Ingham Institute for Applied Medical Research (S.H.), University of New South Wales Medicine, Sydney, Australia; Department of Neurology (T.D.), University Hospital Basel, Switzerland; Department of Neurology (Andrew Chan), Inselspital, Bern University Hospital, University of Bern, Switzerland; Danish MS Center (F.S.), Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine (F.S.), University of Copenhagen, Denmark; Multiple Sclerosis Center (A.A.), Sheba Academic Medical Center, Ramat Gan, Israel; Sackler School of Medicine (A.A.), Tel-Aviv University, Israel; Department of Neurology-Neuroimmunology (X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences and CRCHUM (A.P.), Université de Montréal, QC, Canada; Department of Neurological and Behavioural Sciences (N.D.S.), University of Siena, Italy; Department of Radiology (F.B.), VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology (F.B.), London, UK; Experimental Neurophysiology Unit (L.L.), Vita-Salute San Raffaele University, Milan, Italy; Univ. Lille (P.V.), Inserm U1172 LilNCog, CHU Lille, FHU Precise, France; Cytel Inc (Anita Chudecka), Geneva, Switzerland; InScience Communications (C.M.), Springer Healthcare Ltd, Chester, UK; EMD Serono (K.H.H.), Billerica, MA; and Ares Trading SA (U.B., S.R.), Eysins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany.
| | - Klaus Schmierer
- From the Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany and Brain and Mind Center, University of Sydney, Australia; The Blizard Institute (K.S.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience) (K.S.), The Royal London Hospital, Barts Health NHS Trust, UK; Ingham Institute for Applied Medical Research (S.H.), University of New South Wales Medicine, Sydney, Australia; Department of Neurology (T.D.), University Hospital Basel, Switzerland; Department of Neurology (Andrew Chan), Inselspital, Bern University Hospital, University of Bern, Switzerland; Danish MS Center (F.S.), Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine (F.S.), University of Copenhagen, Denmark; Multiple Sclerosis Center (A.A.), Sheba Academic Medical Center, Ramat Gan, Israel; Sackler School of Medicine (A.A.), Tel-Aviv University, Israel; Department of Neurology-Neuroimmunology (X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences and CRCHUM (A.P.), Université de Montréal, QC, Canada; Department of Neurological and Behavioural Sciences (N.D.S.), University of Siena, Italy; Department of Radiology (F.B.), VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology (F.B.), London, UK; Experimental Neurophysiology Unit (L.L.), Vita-Salute San Raffaele University, Milan, Italy; Univ. Lille (P.V.), Inserm U1172 LilNCog, CHU Lille, FHU Precise, France; Cytel Inc (Anita Chudecka), Geneva, Switzerland; InScience Communications (C.M.), Springer Healthcare Ltd, Chester, UK; EMD Serono (K.H.H.), Billerica, MA; and Ares Trading SA (U.B., S.R.), Eysins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Suzanne Hodgkinson
- From the Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany and Brain and Mind Center, University of Sydney, Australia; The Blizard Institute (K.S.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience) (K.S.), The Royal London Hospital, Barts Health NHS Trust, UK; Ingham Institute for Applied Medical Research (S.H.), University of New South Wales Medicine, Sydney, Australia; Department of Neurology (T.D.), University Hospital Basel, Switzerland; Department of Neurology (Andrew Chan), Inselspital, Bern University Hospital, University of Bern, Switzerland; Danish MS Center (F.S.), Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine (F.S.), University of Copenhagen, Denmark; Multiple Sclerosis Center (A.A.), Sheba Academic Medical Center, Ramat Gan, Israel; Sackler School of Medicine (A.A.), Tel-Aviv University, Israel; Department of Neurology-Neuroimmunology (X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences and CRCHUM (A.P.), Université de Montréal, QC, Canada; Department of Neurological and Behavioural Sciences (N.D.S.), University of Siena, Italy; Department of Radiology (F.B.), VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology (F.B.), London, UK; Experimental Neurophysiology Unit (L.L.), Vita-Salute San Raffaele University, Milan, Italy; Univ. Lille (P.V.), Inserm U1172 LilNCog, CHU Lille, FHU Precise, France; Cytel Inc (Anita Chudecka), Geneva, Switzerland; InScience Communications (C.M.), Springer Healthcare Ltd, Chester, UK; EMD Serono (K.H.H.), Billerica, MA; and Ares Trading SA (U.B., S.R.), Eysins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Tobias Derfuss
- From the Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany and Brain and Mind Center, University of Sydney, Australia; The Blizard Institute (K.S.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience) (K.S.), The Royal London Hospital, Barts Health NHS Trust, UK; Ingham Institute for Applied Medical Research (S.H.), University of New South Wales Medicine, Sydney, Australia; Department of Neurology (T.D.), University Hospital Basel, Switzerland; Department of Neurology (Andrew Chan), Inselspital, Bern University Hospital, University of Bern, Switzerland; Danish MS Center (F.S.), Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine (F.S.), University of Copenhagen, Denmark; Multiple Sclerosis Center (A.A.), Sheba Academic Medical Center, Ramat Gan, Israel; Sackler School of Medicine (A.A.), Tel-Aviv University, Israel; Department of Neurology-Neuroimmunology (X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences and CRCHUM (A.P.), Université de Montréal, QC, Canada; Department of Neurological and Behavioural Sciences (N.D.S.), University of Siena, Italy; Department of Radiology (F.B.), VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology (F.B.), London, UK; Experimental Neurophysiology Unit (L.L.), Vita-Salute San Raffaele University, Milan, Italy; Univ. Lille (P.V.), Inserm U1172 LilNCog, CHU Lille, FHU Precise, France; Cytel Inc (Anita Chudecka), Geneva, Switzerland; InScience Communications (C.M.), Springer Healthcare Ltd, Chester, UK; EMD Serono (K.H.H.), Billerica, MA; and Ares Trading SA (U.B., S.R.), Eysins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Andrew Chan
- From the Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany and Brain and Mind Center, University of Sydney, Australia; The Blizard Institute (K.S.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience) (K.S.), The Royal London Hospital, Barts Health NHS Trust, UK; Ingham Institute for Applied Medical Research (S.H.), University of New South Wales Medicine, Sydney, Australia; Department of Neurology (T.D.), University Hospital Basel, Switzerland; Department of Neurology (Andrew Chan), Inselspital, Bern University Hospital, University of Bern, Switzerland; Danish MS Center (F.S.), Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine (F.S.), University of Copenhagen, Denmark; Multiple Sclerosis Center (A.A.), Sheba Academic Medical Center, Ramat Gan, Israel; Sackler School of Medicine (A.A.), Tel-Aviv University, Israel; Department of Neurology-Neuroimmunology (X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences and CRCHUM (A.P.), Université de Montréal, QC, Canada; Department of Neurological and Behavioural Sciences (N.D.S.), University of Siena, Italy; Department of Radiology (F.B.), VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology (F.B.), London, UK; Experimental Neurophysiology Unit (L.L.), Vita-Salute San Raffaele University, Milan, Italy; Univ. Lille (P.V.), Inserm U1172 LilNCog, CHU Lille, FHU Precise, France; Cytel Inc (Anita Chudecka), Geneva, Switzerland; InScience Communications (C.M.), Springer Healthcare Ltd, Chester, UK; EMD Serono (K.H.H.), Billerica, MA; and Ares Trading SA (U.B., S.R.), Eysins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Finn Sellebjerg
- From the Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany and Brain and Mind Center, University of Sydney, Australia; The Blizard Institute (K.S.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience) (K.S.), The Royal London Hospital, Barts Health NHS Trust, UK; Ingham Institute for Applied Medical Research (S.H.), University of New South Wales Medicine, Sydney, Australia; Department of Neurology (T.D.), University Hospital Basel, Switzerland; Department of Neurology (Andrew Chan), Inselspital, Bern University Hospital, University of Bern, Switzerland; Danish MS Center (F.S.), Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine (F.S.), University of Copenhagen, Denmark; Multiple Sclerosis Center (A.A.), Sheba Academic Medical Center, Ramat Gan, Israel; Sackler School of Medicine (A.A.), Tel-Aviv University, Israel; Department of Neurology-Neuroimmunology (X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences and CRCHUM (A.P.), Université de Montréal, QC, Canada; Department of Neurological and Behavioural Sciences (N.D.S.), University of Siena, Italy; Department of Radiology (F.B.), VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology (F.B.), London, UK; Experimental Neurophysiology Unit (L.L.), Vita-Salute San Raffaele University, Milan, Italy; Univ. Lille (P.V.), Inserm U1172 LilNCog, CHU Lille, FHU Precise, France; Cytel Inc (Anita Chudecka), Geneva, Switzerland; InScience Communications (C.M.), Springer Healthcare Ltd, Chester, UK; EMD Serono (K.H.H.), Billerica, MA; and Ares Trading SA (U.B., S.R.), Eysins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Anat Achiron
- From the Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany and Brain and Mind Center, University of Sydney, Australia; The Blizard Institute (K.S.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience) (K.S.), The Royal London Hospital, Barts Health NHS Trust, UK; Ingham Institute for Applied Medical Research (S.H.), University of New South Wales Medicine, Sydney, Australia; Department of Neurology (T.D.), University Hospital Basel, Switzerland; Department of Neurology (Andrew Chan), Inselspital, Bern University Hospital, University of Bern, Switzerland; Danish MS Center (F.S.), Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine (F.S.), University of Copenhagen, Denmark; Multiple Sclerosis Center (A.A.), Sheba Academic Medical Center, Ramat Gan, Israel; Sackler School of Medicine (A.A.), Tel-Aviv University, Israel; Department of Neurology-Neuroimmunology (X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences and CRCHUM (A.P.), Université de Montréal, QC, Canada; Department of Neurological and Behavioural Sciences (N.D.S.), University of Siena, Italy; Department of Radiology (F.B.), VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology (F.B.), London, UK; Experimental Neurophysiology Unit (L.L.), Vita-Salute San Raffaele University, Milan, Italy; Univ. Lille (P.V.), Inserm U1172 LilNCog, CHU Lille, FHU Precise, France; Cytel Inc (Anita Chudecka), Geneva, Switzerland; InScience Communications (C.M.), Springer Healthcare Ltd, Chester, UK; EMD Serono (K.H.H.), Billerica, MA; and Ares Trading SA (U.B., S.R.), Eysins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Xavier Montalban
- From the Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany and Brain and Mind Center, University of Sydney, Australia; The Blizard Institute (K.S.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience) (K.S.), The Royal London Hospital, Barts Health NHS Trust, UK; Ingham Institute for Applied Medical Research (S.H.), University of New South Wales Medicine, Sydney, Australia; Department of Neurology (T.D.), University Hospital Basel, Switzerland; Department of Neurology (Andrew Chan), Inselspital, Bern University Hospital, University of Bern, Switzerland; Danish MS Center (F.S.), Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine (F.S.), University of Copenhagen, Denmark; Multiple Sclerosis Center (A.A.), Sheba Academic Medical Center, Ramat Gan, Israel; Sackler School of Medicine (A.A.), Tel-Aviv University, Israel; Department of Neurology-Neuroimmunology (X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences and CRCHUM (A.P.), Université de Montréal, QC, Canada; Department of Neurological and Behavioural Sciences (N.D.S.), University of Siena, Italy; Department of Radiology (F.B.), VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology (F.B.), London, UK; Experimental Neurophysiology Unit (L.L.), Vita-Salute San Raffaele University, Milan, Italy; Univ. Lille (P.V.), Inserm U1172 LilNCog, CHU Lille, FHU Precise, France; Cytel Inc (Anita Chudecka), Geneva, Switzerland; InScience Communications (C.M.), Springer Healthcare Ltd, Chester, UK; EMD Serono (K.H.H.), Billerica, MA; and Ares Trading SA (U.B., S.R.), Eysins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Alexandre Prat
- From the Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany and Brain and Mind Center, University of Sydney, Australia; The Blizard Institute (K.S.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience) (K.S.), The Royal London Hospital, Barts Health NHS Trust, UK; Ingham Institute for Applied Medical Research (S.H.), University of New South Wales Medicine, Sydney, Australia; Department of Neurology (T.D.), University Hospital Basel, Switzerland; Department of Neurology (Andrew Chan), Inselspital, Bern University Hospital, University of Bern, Switzerland; Danish MS Center (F.S.), Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine (F.S.), University of Copenhagen, Denmark; Multiple Sclerosis Center (A.A.), Sheba Academic Medical Center, Ramat Gan, Israel; Sackler School of Medicine (A.A.), Tel-Aviv University, Israel; Department of Neurology-Neuroimmunology (X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences and CRCHUM (A.P.), Université de Montréal, QC, Canada; Department of Neurological and Behavioural Sciences (N.D.S.), University of Siena, Italy; Department of Radiology (F.B.), VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology (F.B.), London, UK; Experimental Neurophysiology Unit (L.L.), Vita-Salute San Raffaele University, Milan, Italy; Univ. Lille (P.V.), Inserm U1172 LilNCog, CHU Lille, FHU Precise, France; Cytel Inc (Anita Chudecka), Geneva, Switzerland; InScience Communications (C.M.), Springer Healthcare Ltd, Chester, UK; EMD Serono (K.H.H.), Billerica, MA; and Ares Trading SA (U.B., S.R.), Eysins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Nicola De Stefano
- From the Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany and Brain and Mind Center, University of Sydney, Australia; The Blizard Institute (K.S.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience) (K.S.), The Royal London Hospital, Barts Health NHS Trust, UK; Ingham Institute for Applied Medical Research (S.H.), University of New South Wales Medicine, Sydney, Australia; Department of Neurology (T.D.), University Hospital Basel, Switzerland; Department of Neurology (Andrew Chan), Inselspital, Bern University Hospital, University of Bern, Switzerland; Danish MS Center (F.S.), Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine (F.S.), University of Copenhagen, Denmark; Multiple Sclerosis Center (A.A.), Sheba Academic Medical Center, Ramat Gan, Israel; Sackler School of Medicine (A.A.), Tel-Aviv University, Israel; Department of Neurology-Neuroimmunology (X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences and CRCHUM (A.P.), Université de Montréal, QC, Canada; Department of Neurological and Behavioural Sciences (N.D.S.), University of Siena, Italy; Department of Radiology (F.B.), VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology (F.B.), London, UK; Experimental Neurophysiology Unit (L.L.), Vita-Salute San Raffaele University, Milan, Italy; Univ. Lille (P.V.), Inserm U1172 LilNCog, CHU Lille, FHU Precise, France; Cytel Inc (Anita Chudecka), Geneva, Switzerland; InScience Communications (C.M.), Springer Healthcare Ltd, Chester, UK; EMD Serono (K.H.H.), Billerica, MA; and Ares Trading SA (U.B., S.R.), Eysins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Frederik Barkhof
- From the Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany and Brain and Mind Center, University of Sydney, Australia; The Blizard Institute (K.S.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience) (K.S.), The Royal London Hospital, Barts Health NHS Trust, UK; Ingham Institute for Applied Medical Research (S.H.), University of New South Wales Medicine, Sydney, Australia; Department of Neurology (T.D.), University Hospital Basel, Switzerland; Department of Neurology (Andrew Chan), Inselspital, Bern University Hospital, University of Bern, Switzerland; Danish MS Center (F.S.), Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine (F.S.), University of Copenhagen, Denmark; Multiple Sclerosis Center (A.A.), Sheba Academic Medical Center, Ramat Gan, Israel; Sackler School of Medicine (A.A.), Tel-Aviv University, Israel; Department of Neurology-Neuroimmunology (X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences and CRCHUM (A.P.), Université de Montréal, QC, Canada; Department of Neurological and Behavioural Sciences (N.D.S.), University of Siena, Italy; Department of Radiology (F.B.), VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology (F.B.), London, UK; Experimental Neurophysiology Unit (L.L.), Vita-Salute San Raffaele University, Milan, Italy; Univ. Lille (P.V.), Inserm U1172 LilNCog, CHU Lille, FHU Precise, France; Cytel Inc (Anita Chudecka), Geneva, Switzerland; InScience Communications (C.M.), Springer Healthcare Ltd, Chester, UK; EMD Serono (K.H.H.), Billerica, MA; and Ares Trading SA (U.B., S.R.), Eysins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Letizia Leocani
- From the Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany and Brain and Mind Center, University of Sydney, Australia; The Blizard Institute (K.S.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience) (K.S.), The Royal London Hospital, Barts Health NHS Trust, UK; Ingham Institute for Applied Medical Research (S.H.), University of New South Wales Medicine, Sydney, Australia; Department of Neurology (T.D.), University Hospital Basel, Switzerland; Department of Neurology (Andrew Chan), Inselspital, Bern University Hospital, University of Bern, Switzerland; Danish MS Center (F.S.), Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine (F.S.), University of Copenhagen, Denmark; Multiple Sclerosis Center (A.A.), Sheba Academic Medical Center, Ramat Gan, Israel; Sackler School of Medicine (A.A.), Tel-Aviv University, Israel; Department of Neurology-Neuroimmunology (X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences and CRCHUM (A.P.), Université de Montréal, QC, Canada; Department of Neurological and Behavioural Sciences (N.D.S.), University of Siena, Italy; Department of Radiology (F.B.), VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology (F.B.), London, UK; Experimental Neurophysiology Unit (L.L.), Vita-Salute San Raffaele University, Milan, Italy; Univ. Lille (P.V.), Inserm U1172 LilNCog, CHU Lille, FHU Precise, France; Cytel Inc (Anita Chudecka), Geneva, Switzerland; InScience Communications (C.M.), Springer Healthcare Ltd, Chester, UK; EMD Serono (K.H.H.), Billerica, MA; and Ares Trading SA (U.B., S.R.), Eysins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Patrick Vermersch
- From the Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany and Brain and Mind Center, University of Sydney, Australia; The Blizard Institute (K.S.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience) (K.S.), The Royal London Hospital, Barts Health NHS Trust, UK; Ingham Institute for Applied Medical Research (S.H.), University of New South Wales Medicine, Sydney, Australia; Department of Neurology (T.D.), University Hospital Basel, Switzerland; Department of Neurology (Andrew Chan), Inselspital, Bern University Hospital, University of Bern, Switzerland; Danish MS Center (F.S.), Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine (F.S.), University of Copenhagen, Denmark; Multiple Sclerosis Center (A.A.), Sheba Academic Medical Center, Ramat Gan, Israel; Sackler School of Medicine (A.A.), Tel-Aviv University, Israel; Department of Neurology-Neuroimmunology (X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences and CRCHUM (A.P.), Université de Montréal, QC, Canada; Department of Neurological and Behavioural Sciences (N.D.S.), University of Siena, Italy; Department of Radiology (F.B.), VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology (F.B.), London, UK; Experimental Neurophysiology Unit (L.L.), Vita-Salute San Raffaele University, Milan, Italy; Univ. Lille (P.V.), Inserm U1172 LilNCog, CHU Lille, FHU Precise, France; Cytel Inc (Anita Chudecka), Geneva, Switzerland; InScience Communications (C.M.), Springer Healthcare Ltd, Chester, UK; EMD Serono (K.H.H.), Billerica, MA; and Ares Trading SA (U.B., S.R.), Eysins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Anita Chudecka
- From the Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany and Brain and Mind Center, University of Sydney, Australia; The Blizard Institute (K.S.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience) (K.S.), The Royal London Hospital, Barts Health NHS Trust, UK; Ingham Institute for Applied Medical Research (S.H.), University of New South Wales Medicine, Sydney, Australia; Department of Neurology (T.D.), University Hospital Basel, Switzerland; Department of Neurology (Andrew Chan), Inselspital, Bern University Hospital, University of Bern, Switzerland; Danish MS Center (F.S.), Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine (F.S.), University of Copenhagen, Denmark; Multiple Sclerosis Center (A.A.), Sheba Academic Medical Center, Ramat Gan, Israel; Sackler School of Medicine (A.A.), Tel-Aviv University, Israel; Department of Neurology-Neuroimmunology (X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences and CRCHUM (A.P.), Université de Montréal, QC, Canada; Department of Neurological and Behavioural Sciences (N.D.S.), University of Siena, Italy; Department of Radiology (F.B.), VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology (F.B.), London, UK; Experimental Neurophysiology Unit (L.L.), Vita-Salute San Raffaele University, Milan, Italy; Univ. Lille (P.V.), Inserm U1172 LilNCog, CHU Lille, FHU Precise, France; Cytel Inc (Anita Chudecka), Geneva, Switzerland; InScience Communications (C.M.), Springer Healthcare Ltd, Chester, UK; EMD Serono (K.H.H.), Billerica, MA; and Ares Trading SA (U.B., S.R.), Eysins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Claire Mwape
- From the Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany and Brain and Mind Center, University of Sydney, Australia; The Blizard Institute (K.S.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience) (K.S.), The Royal London Hospital, Barts Health NHS Trust, UK; Ingham Institute for Applied Medical Research (S.H.), University of New South Wales Medicine, Sydney, Australia; Department of Neurology (T.D.), University Hospital Basel, Switzerland; Department of Neurology (Andrew Chan), Inselspital, Bern University Hospital, University of Bern, Switzerland; Danish MS Center (F.S.), Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine (F.S.), University of Copenhagen, Denmark; Multiple Sclerosis Center (A.A.), Sheba Academic Medical Center, Ramat Gan, Israel; Sackler School of Medicine (A.A.), Tel-Aviv University, Israel; Department of Neurology-Neuroimmunology (X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences and CRCHUM (A.P.), Université de Montréal, QC, Canada; Department of Neurological and Behavioural Sciences (N.D.S.), University of Siena, Italy; Department of Radiology (F.B.), VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology (F.B.), London, UK; Experimental Neurophysiology Unit (L.L.), Vita-Salute San Raffaele University, Milan, Italy; Univ. Lille (P.V.), Inserm U1172 LilNCog, CHU Lille, FHU Precise, France; Cytel Inc (Anita Chudecka), Geneva, Switzerland; InScience Communications (C.M.), Springer Healthcare Ltd, Chester, UK; EMD Serono (K.H.H.), Billerica, MA; and Ares Trading SA (U.B., S.R.), Eysins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Kristina H Holmberg
- From the Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany and Brain and Mind Center, University of Sydney, Australia; The Blizard Institute (K.S.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience) (K.S.), The Royal London Hospital, Barts Health NHS Trust, UK; Ingham Institute for Applied Medical Research (S.H.), University of New South Wales Medicine, Sydney, Australia; Department of Neurology (T.D.), University Hospital Basel, Switzerland; Department of Neurology (Andrew Chan), Inselspital, Bern University Hospital, University of Bern, Switzerland; Danish MS Center (F.S.), Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine (F.S.), University of Copenhagen, Denmark; Multiple Sclerosis Center (A.A.), Sheba Academic Medical Center, Ramat Gan, Israel; Sackler School of Medicine (A.A.), Tel-Aviv University, Israel; Department of Neurology-Neuroimmunology (X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences and CRCHUM (A.P.), Université de Montréal, QC, Canada; Department of Neurological and Behavioural Sciences (N.D.S.), University of Siena, Italy; Department of Radiology (F.B.), VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology (F.B.), London, UK; Experimental Neurophysiology Unit (L.L.), Vita-Salute San Raffaele University, Milan, Italy; Univ. Lille (P.V.), Inserm U1172 LilNCog, CHU Lille, FHU Precise, France; Cytel Inc (Anita Chudecka), Geneva, Switzerland; InScience Communications (C.M.), Springer Healthcare Ltd, Chester, UK; EMD Serono (K.H.H.), Billerica, MA; and Ares Trading SA (U.B., S.R.), Eysins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Ursula Boschert
- From the Department of Neurology with Institute of Translational Neurology (H.W.), University of Münster, Germany and Brain and Mind Center, University of Sydney, Australia; The Blizard Institute (K.S.), Centre for Neuroscience, Surgery & Trauma, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK; Clinical Board Medicine (Neuroscience) (K.S.), The Royal London Hospital, Barts Health NHS Trust, UK; Ingham Institute for Applied Medical Research (S.H.), University of New South Wales Medicine, Sydney, Australia; Department of Neurology (T.D.), University Hospital Basel, Switzerland; Department of Neurology (Andrew Chan), Inselspital, Bern University Hospital, University of Bern, Switzerland; Danish MS Center (F.S.), Department of Neurology, Copenhagen University Hospital-Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine (F.S.), University of Copenhagen, Denmark; Multiple Sclerosis Center (A.A.), Sheba Academic Medical Center, Ramat Gan, Israel; Sackler School of Medicine (A.A.), Tel-Aviv University, Israel; Department of Neurology-Neuroimmunology (X.M.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autonoma de Barcelona, Spain; Department of Neurosciences and CRCHUM (A.P.), Université de Montréal, QC, Canada; Department of Neurological and Behavioural Sciences (N.D.S.), University of Siena, Italy; Department of Radiology (F.B.), VU University Medical Center, Amsterdam, The Netherlands; UCL Institute of Neurology (F.B.), London, UK; Experimental Neurophysiology Unit (L.L.), Vita-Salute San Raffaele University, Milan, Italy; Univ. Lille (P.V.), Inserm U1172 LilNCog, CHU Lille, FHU Precise, France; Cytel Inc (Anita Chudecka), Geneva, Switzerland; InScience Communications (C.M.), Springer Healthcare Ltd, Chester, UK; EMD Serono (K.H.H.), Billerica, MA; and Ares Trading SA (U.B., S.R.), Eysins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany
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Simpson-Yap S, Pirmani A, Kalincik T, De Brouwer E, Geys L, Parciak T, Helme A, Rijke N, Hillert JA, Moreau Y, Edan G, Sharmin S, Spelman T, McBurney R, Schmidt H, Bergmann AB, Braune S, Stahmann A, Middleton RM, Salter A, Bebo B, Van der Walt A, Butzkueven H, Ozakbas S, Boz C, Karabudak R, Alroughani R, Rojas JI, van der Mei IA, Sciascia do Olival G, Magyari M, Alonso RN, Nicholas RS, Chertcoff AS, de Torres AZ, Arrambide G, Nag N, Descamps A, Costers L, Dobson R, Miller A, Rodrigues P, Prčkovska V, Comi G, Peeters LM. Updated Results of the COVID-19 in MS Global Data Sharing Initiative. Neurol Neuroimmunol Neuroinflamm 2022; 9:9/6/e200021. [PMID: 36038263 PMCID: PMC9423711 DOI: 10.1212/nxi.0000000000200021] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 07/27/2022] [Indexed: 11/18/2022]
Abstract
Background and Objectives Certain demographic and clinical characteristics, including the use of some disease-modifying therapies (DMTs), are associated with severe acute respiratory syndrome coronavirus 2 infection severity in people with multiple sclerosis (MS). Comprehensive exploration of these relationships in large international samples is needed. Methods Clinician-reported demographic/clinical data from 27 countries were aggregated into a data set of 5,648 patients with suspected/confirmed coronavirus disease 2019 (COVID-19). COVID-19 severity outcomes (hospitalization, admission to intensive care unit [ICU], requiring artificial ventilation, and death) were assessed using multilevel mixed-effects ordered probit and logistic regression, adjusted for age, sex, disability, and MS phenotype. DMTs were individually compared with glatiramer acetate, and anti-CD20 DMTs with pooled other DMTs and with natalizumab. Results Of 5,648 patients, 922 (16.6%) with suspected and 4,646 (83.4%) with confirmed COVID-19 were included. Male sex, older age, progressive MS, and higher disability were associated with more severe COVID-19. Compared with glatiramer acetate, ocrelizumab and rituximab were associated with higher probabilities of hospitalization (4% [95% CI 1–7] and 7% [95% CI 4–11]), ICU/artificial ventilation (2% [95% CI 0–4] and 4% [95% CI 2–6]), and death (1% [95% CI 0–2] and 2% [95% CI 1–4]) (predicted marginal effects). Untreated patients had 5% (95% CI 2–8), 3% (95% CI 1–5), and 1% (95% CI 0–3) higher probabilities of the 3 respective levels of COVID-19 severity than glatiramer acetate. Compared with pooled other DMTs and with natalizumab, the associations of ocrelizumab and rituximab with COVID-19 severity were also more pronounced. All associations persisted/enhanced on restriction to confirmed COVID-19. Discussion Analyzing the largest international real-world data set of people with MS with suspected/confirmed COVID-19 confirms that the use of anti-CD20 medication (both ocrelizumab and rituximab), as well as male sex, older age, progressive MS, and higher disability are associated with more severe course of COVID-19.
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Affiliation(s)
- Steve Simpson-Yap
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy.
| | - Ashkan Pirmani
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Tomas Kalincik
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Edward De Brouwer
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Lotte Geys
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Tina Parciak
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Anne Helme
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Nick Rijke
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Jan A Hillert
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Yves Moreau
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Gilles Edan
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Sifat Sharmin
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Tim Spelman
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Robert McBurney
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Hollie Schmidt
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Arnfin B Bergmann
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Stefan Braune
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Alexander Stahmann
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Rod M Middleton
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Amber Salter
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Bruce Bebo
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Anneke Van der Walt
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Helmut Butzkueven
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Serkan Ozakbas
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Cavit Boz
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Rana Karabudak
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Raed Alroughani
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Juan I Rojas
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Ingrid A van der Mei
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Guilherme Sciascia do Olival
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Melinda Magyari
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Ricardo N Alonso
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Richard S Nicholas
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Anibal S Chertcoff
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Ana Zabalza de Torres
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Georgina Arrambide
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Nupur Nag
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Annabel Descamps
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Lars Costers
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Ruth Dobson
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Aleisha Miller
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Paulo Rodrigues
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Vesna Prčkovska
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Giancarlo Comi
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
| | - Liesbet M Peeters
- From the CORe (S.S.-Y., T.K., S.S.), Department of Medicine, and Neuroepidemiology Unit (S.S.-Y., N.N.), Melbourne School of Population & Global Health, The University of Melbourne; Menzies Institute for Medical Research (S.S.-Y.), University of Tasmania, Australia; ESAT-STADIUS (A.P., E.D.B., L.G., T.P., Y.M.), KU Leuven; Biomedical Research Institute-Data Science Institute (A.P., L.G., T.P.), Hasselt University, Belgium; MS Centre (T.K., L.M.P.), Department of Neurology, Royal Melbourne Hospital, Australia; Department of Medical Informatics (T.K.), University Medical Center Göttingen, Germany; MS International Federation (A.H., N.R.), London, United Kingdom; Department of Clinical Neuroscience (J.A.H., T.S.), Swedish MS Registry, Karolinska Institutet, Sweden; Department of Neurology (G.E.), CHU Pontchaillou, France; iConquerMS People-Powered Research Network (R.M., H.S.), Accelerated Cure Project for MS, Waltham, MA; NeuroTransData Study Group (A.B.B., S.B.), NeuroTransData, Neuburg an der Donau, Germany; German MS-Register by the National MS Society (A. Stahmann), MS Forschungs- und Projektentwicklungs-gGmbH; UK MS Register (R.M.M., R.S.N.), Swansea University; COViMS (A. Salter, B.B.); Division of Biostatistics (A. Salter), Washington University in St. Louis; Department of Neuroscience (A.V.d.W., H.B.), Central Clinical School, Monash University, Australia; Dokuz Eylul University (S.O.), İzmir; Department of Neurology (C.B.), Karadeniz Technical University, Trabzon; Department of Neurology (R.K.), University of Hacettepe, Turkey; Amiri Hospital (R.A.), Kuwait; Neurology Department (J.I.R.), Hospital Universitario de CEMIC; RELACOEM (J.I.R., R.N.A.), Buenos Aires, Argentina; The Australian MS Longitudinal Study (I.A.v.d.M.), Menzies Institute for Medical Research, University of Tasmania; ABEM-Brazilian MS Patients Association (G.S.d.O.); The Danish Multiple Sclerosis Registry (M.M.), Departement of Neurology, University Hospital Rigshospitalet, Denmark; Multiple Sclerosis University Center (R.N.A.), Ramos Mejia Hospital-EMA, Argentina; Imperial College London (R.S.N., A.M.), United Kingdom; MS and Demyelinating Diseases, Hospital Británico de Buenos Aires (A.S.C.), EMA, Argentina; Servei de Neurologia-Neuroimmunologia (A.Z.d.T., G.A.), Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Universitat Autònoma de Barcelona, Spain; icometrix (A.D., L.C.), Leuven, Belgium; Queen Mary University London (R.D.), United Kingdom; QMENTA (P.R., V.P.), Barcelona, Spain; and Casa di Cura del Policlinico and Università Vita Salute San Raffaele (G.C.), Italy
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