"Unveiling the Silent Progression of Multiple Sclerosis: Ignoring Treatments"

Silent progression, also known as progression independent of relapse activity (PIRA), is a common phenomenon in multiple sclerosis (MS) where disability worsens without experiencing relapses. A review of studies suggests that PIRA accounts for at least 50% of reported instances of disability worsening in people with relapsing-remitting MS. Additionally, factors such as medication side effects, cost, and the form of treatment (injections, infusions, or pills) can influence MS patients' adherence to their treatments. The author questions the labeling of MS stages and emphasizes the importance of considering cost when making treatment decisions.