Progression independent of relapse activity (PIRA) was a term coined a decade ago to describe the insidious disability worsening that occurs in multiple sclerosis during relapse-free periods due to neurodegenerative processes such as smouldering inflammation. A new study reports that 2.5% of patients with neuromyelitis optica spectrum disorder (NMOSD) also have PIRA events during long-term follow-up (Kang et al. Neurol Neuroimmunol Neuroinflamm 2026;13:e200533). Read More
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Adjunctive therapy in focal epilepsy – highlights from AES 2025
December 23, 2025Real-world use of cenobamate
New phase III data
Effect on mortality
Co-administration with cannabidiol
The International League Against Epilepsy (ILAE) published its updated classification of epileptic seizures earlier this year, maintaining four seizure classes (Focal, Generalized, Unknown, Unclassified) and 21 seizure types (Beniczky et al. Epilepsia 2025;66:1804-1823). For example, focal seizures may be classified as focal preserved consciousness (FPC), focal impaired consciousness (FIC) or focal-to-bilateral tonic-clonic seizures (FBTC). Consciousness was defined by awareness (i.e. recall of events) and responsiveness. The basic descriptors are whether seizures have observable manifestations or not.
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MS biomarkers – the year in review
December 16, 2025Neurofilament-light chain
Kappa free-light chain
Combining biomarkers
MS biomarker research this year was characterized by further refinements to how current fluid biomarkers may be employed in practice; new/emerging markers of disease; and the use of combined biomarkers that may help to unravel the complex pathobiology of disease progression.
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High-efficacy DMTs for MS: the year in review
December 1, 2025Click here to complete the interactive survey on DMTs.
Once you submit your responses, you will be able to view all of your colleagues’ responses.
Early use of HE-DMTs
Use in pregnancy
Noteworthy studies in 2025
Switching between anti-CD20 agents
The year 2025 saw an increasing early use of high-efficacy disease-modifying therapies (HE-DMT) in patients with multiple sclerosis, either as the first-choice agent or for the first switch. The rationale for this change in practice patterns derived from the accumulating efficacy and safety data from clinical trials, database analyses and real-world studies on the use of anti-CD20 monoclonal antibodies.
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