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In this issue of the journal, an epidemiological study using global multiple sclerosis (MS) database is published that investigated prognostic factors in advanced stages of MS.1 The cohort analysed included prospectively collected data of over 3000 patients with MS, and among various factors comprised demographics, age at onset, disease duration, annualised relapse rate, disability as rated by Expanded Disability Status Scale (EDSS) and history of immunotherapies. By dividing disease stage in three subgroups or ‘epochs’ as called by the authors (EDSS 3–6, 4–6 and 6–6.5) one of the relevant findings was that previous disease activity before entering advanced stages of MS had no impact on disease progression in later stages. Another important, and rather encouraging, finding was that …
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