Toward a Unified Definition of Progression Independent of Relapse Activity in Multiple Sclerosis
The definition of PIRA combining roving baseline, no relapses 90 days before and 30 days after the event and 24-week confirmation achieved the best predictive value and feasibility, supporting its use in routine practice and research.
Authors
- Pietro Osvaldo Luigi Annovazzi (ORCID: https://orcid.org/0000-0003-0279-0707)
- Massimo Filippi (ORCID: https://orcid.org/0000-0002-5485-0479)
- Diana Ferraro (ORCID: https://orcid.org/0000-0003-4818-3806)
- Carla Tortorella (ORCID: https://orcid.org/0000-0001-9037-7300)
- Elio Prestipino (ORCID: https://orcid.org/0000-0001-6930-887X)
- María Trojano (ORCID: https://orcid.org/0000-0002-6329-8946)
- Matteo Betti (ORCID: https://orcid.org/0009-0008-8458-3747)
- Alessandra Lugaresi (ORCID: https://orcid.org/0000-0003-2902-5589)
- Emilio Portaccio (ORCID: https://orcid.org/0000-0002-9662-1762)
- Alessia Di Sapio (ORCID: https://orcid.org/0000-0002-5575-7567)
- Maria Pia Amato (ORCID: https://orcid.org/0000-0003-3325-3760)
- Pietro Iaffaldano (ORCID: https://orcid.org/0000-0003-2308-1731)
- Raffaella Cerqua
- Giovanna De Luca (ORCID: https://orcid.org/0000-0002-7693-2256)
- Luisa Pastò
- Ermelinda De Meo (ORCID: https://orcid.org/0000-0001-5531-1111)
- Marta Simone (ORCID: https://orcid.org/0000-0003-4381-4613)
- Francesco Patti (ORCID: https://orcid.org/0000-0002-6923-0846)
- Giuseppe Salemi (ORCID: https://orcid.org/0000-0002-3756-4323)
- Silvia Romano (ORCID: https://orcid.org/0000-0003-0499-8843)
- Carlo Pozzilli (ORCID: https://orcid.org/0000-0002-6360-4798)
- Maria Assunta Rocca (ORCID: https://orcid.org/0000-0003-2358-4320)
- Eleonora E. Cocco (ORCID: https://orcid.org/0000-0002-3878-8820)
- Vincenzo Brescia Morra (ORCID: https://orcid.org/0000-0003-0462-9618)
- Marika Vianello (ORCID: https://orcid.org/0009-0006-0864-7230)
- Maria Barbara Pasanisi
- Paola Perini (ORCID: https://orcid.org/0009-0008-9628-1180)
- Matilde Inglese
Institutions
- Marche Polytechnic University (IT)
- Vita-Salute San Raffaele University (IT)
- Policlinico Umberto I (IT)
- University of Catania (IT)
- Associazione Italiana Sclerosi Multipla (IT)
- Azienda Unita' Sanitaria Locale Di Modena (IT)
- Azienda Ospedaliero-Universitaria Careggi (IT)
- Don Carlo Gnocchi Foundation (IT)
- Federico II University Hospital (IT)
- Istituto delle Scienze Neurologiche di Bologna (IT)
- Azienda Ospedaliera Sant'Andrea (IT)
- Ca' Foncello Hospital (IT)
- Ospedale Policlinico San Martino (IT)
- Azienda Ospedale - Università Padova (IT)
- Ospedale SS. Annunziata (IT)
- Ospedale San Luigi Gonzaga (IT)
- Fondazione IRCCS Istituto Neurologico Carlo Besta (IT)
- University of Florence (IT)
- University of Bari Aldo Moro (IT)
- University of Genoa (IT)
- Sapienza University of Rome (IT)
- University of Palermo (IT)
- University of Bologna (IT)
Publication Details
- Journal
- Neurology
- Published
- 2025-09-22
- DOI
- https://doi.org/10.1212/wnl.0000000000213977
- Citations
- 1
- Primary Topic
- Multiple Sclerosis Research Studies
- Type
- article
- Field-Weighted Citation Impact
- 1.47
Funders
- National Multiple Sclerosis Society
- Bristol-Myers Squibb
- Eli Lilly and Company
- AstraZeneca
- Sanofi
- Biogen
- Teva Pharmaceutical Industries
- Alexion Pharmaceuticals
- Celgene
- Fondazione Italiana Sclerosi Multipla
- Horizon Therapeutics
- Multiple Sclerosis Society of Canada
- Ministero della Salute
- Fondazione Italiana di Ricerca per la Sclerosi Laterale Amiotrofica
- National Institutes of Health