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Reframing Disability In Multiple Sclerosis: Addressing Unmet Needs Beyond Relapse
Ryan Haumschild, PharmD, MS, MBA, CPEL; and Patricia K. Coyle, MD, discuss how progression independent of relapse activity (PIRA) represents a critical driver of disability in multiple sclerosis that requires new therapeutic approaches, biomarkers for early identification, and treatment strategies that address both the relapsing inflammatory component and the underlying smoldering neurodegeneration that manifests clinically around midlife.
EP. 1: Understanding PIRA and Its Clinical Significance in MS
June 27th 2025Panelists discuss how progression independent of relapse activity (PIRA) represents a distinct pathological process involving smoldering inflammation and neurodegeneration that drives disability in patients with multiple sclerosis (MS), particularly manifesting around midlife despite being present from disease onset.
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EP. 2: Measuring What Matters: Evidence and End Points That Define Disability in MS
June 27th 2025Panelists discuss how robust clinical evidence from major studies like the EPIC and OPERA trials demonstrates that progression independent of relapse activity (PIRA) is the primary driver of confirmed disability progression in patients with multiple sclerosis (MS), with clinical parameters over 3 to 6 months being the most meaningful measures of treatment impact.
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