Yi Chao Foong: reports a relationship with Biogen that includes: travel reimbursement. Tim Spelman: received compensation for serving on scientific advisory board for Biogen and speaker honoraria from Novartis. Marzena Fabis-Pedrini: received travel compensation from Merck. Matteo Foschi: received travel and meeting attendance support from Novartis, Biogen, Roche, Sanofi-Genzyme, and Merck. Mario Habek: participated as a clinical investigator and/or received consultation and/or speaker fees from Biogen, Sanofi-Genzyme, Merck, Novartis, Pliva/Teva, Roche, Zentiva, Astra-Zeneca, TG Pharmaceuticals, and CNSystems. Tomas Kalincik: served on scientific advisory boards for the MS International Federation and the World Health Organization, BMS, Roche, Janssen, Sanofi-Genzyme, Novartis, Merck, and Biogen. He served on the steering committee for the Brain Atrophy Initiative by Sanofi-Genzyme, received conference travel support and/or speaker honoraria from WebMD Global, Eisai, Novartis, Biogen, Roche, Sanofi-Genzyme, Teva, BioCSL, and Merck, and received research or educational event support from Biogen, Novartis, Genzyme, Roche, Celgene, and Merck. Izanne Roos: has served on scientific advisory boards and received conference travel support and/or speaker honoraria from Roche, Novartis, Merck, and Biogen. Izanne Roos is supported by MS Australia and the Trish Multiple Sclerosis Research Foundation. Anneke van der Walt: served on advisory boards and receives unrestricted research grants from Novartis, Biogen, Merck, and Roche. She has received speaker’s honoraria and travel support from Novartis, Roche, and Merck. She receives grant support from the National Health and Medical Research Council of Australia and MS Research Australia. Helmut Butzkueven: received institutional (Monash University) funding from Biogen, F. Hoffmann-La Roche Ltd, Merck, Alexion, CSL, and Novartis; has carried out contracted research for Novartis, Merck, F. Hoffmann-La Roche Ltd, and Biogen; has taken part in speakers’ bureaus for Biogen, Genzyme, UCB, Novartis, F. Hoffmann-La Roche Ltd, and Merck; has received personal compensation from the Oxford Health Policy Forum for the Brain Health Steering Committee. Jeannette Lechner-Scott: received travel compensation from Novartis, Biogen, Roche, and Merck. Her institution receives honoraria for talks and advisory board commitments as well as research grants from Biogen, Merck, Roche, TEVA, and Novartis. Nevin John: is a PI on commercial MS studies sponsored by Novartis, Roche, Biogen, and Sanofi. He has received speaker’s honoraria from Merck and conference travel and registration reimbursement from Novartis. “Emanuele D'amico”: has received speaker honoraria and consultant fees from Biogen-Idec, Novartis, Merck, Janssen, Bristol-Myers, Bayer, Sanofi-Genzyme, and Roche. Riadh Gouider: has received research grant and/or advisory board honoraria from Biogen, Hikma, Merck, Roche, and Sanofi. He has no conflict of interest related to this study. Saloua Mrabet: has received a MENACTRIMS clinical fellowship grant (2020). Katrin Gross-Paju: received honoraria as a consultant on scientific advisory boards for Biogen, Roche, and Novartis; has received travel grants from Biogen, Roche, and Novartis; and has participated in clinical trials by Biogen, Merck, Sanofi, Roche, and Novartis. Simón Cárdenas-Robledo: has received travel expenses for scientific meetings from Biopas, Roche, Merck, and Genzyme; compensation for consulting services or participation on advisory boards from Merck, Biogen-Idec, Sanofi, and Novartis; lecture fees from Biopas, Novartis, Merck, Sanofi, Janssen, and Biogen-Idec; and research support from Biogen-Idec and Novartis. He is a subject editor on Multiple Sclerosis for Acta Neurológica Colombiana and a member of the editorial board of Frontiers of Neurology. Abdorreza Naser Moghadasi: has served on scientific advisory boards and received conference travel support and/or speaker honoraria from Roche, Novartis, Genzyme, Merck, and Biogen. Maria Jose Sa: received consulting fees, speaker honoraria, and/or travel expenses for scientific meetings from Alexion, Bayer Healthcare, Biogen, Bristol Myers Squibb, Celgene, Janssen, Merck-Serono, Novartis, Roche, Sanofi, and Teva. Orla Gray: received honoraria as a consultant on scientific advisory boards for Genzyme, Biogen, Merck, Roche, and Novartis; has received travel grants from Biogen, Merck, Roche, and Novartis; has participated in clinical trials by Biogen and Merck. Her institution has received research grant support from Biogen. Jiwon Oh: has received research funding from the MS Society of Canada, National MS Society, Brain Canada, Biogen, Roche, and EMD Serono (an affiliate of Merck KGaA); and personal compensation for consulting or speaking from Alexion, Biogen, Celgene (BMS), EMD Serono (an affiliate of Merck KGaA), Novartis, Roche, and Sanofi-Genzyme. Sudarshini Ramanathan: has received research funding from the National Health and Medical Research Council (NHMRC, Australia), the Petre Foundation, the Brain Foundation, the Royal Australasian College of Physicians, and the University of Sydney. She is supported by an NHMRC Investigator Grant (GNT2008339). She serves as a consultant on the International Steering Committee for a clinical trial led by UCB (NCT05063162). She is on the advisory board for educational activities led by Limbic Neurology. She has been an invited speaker for educational/research sessions coordinated by Biogen, Alexion, Novartis, Excemed, and Limbic Neurology. She is on the medical advisory board (non-remunerated positions) of The MOG Project and the Sumaira Foundation. Ayse Altintas: received speaker honoraria from Novartis and Alexion. Todd A. Hardy: received speaker honoraria/conference travel support or served on advisory boards for Bayer Schering, Biogen, Merck, Novartis, Roche, Sanofi-Genzyme, Bristol Myers Squibb, and Teva. Raed Alroughani: received honoraria as a speaker and for serving on scientific advisory boards from Bayer, Biogen, GSK, Merck, Novartis, Roche, and Sanofi-Genzyme. Allan G Kermode: received speaker honoraria and scientific advisory board fees from Bayer, BioCSL, Biogen, Genzyme, Innate Immunotherapeutics, Merck, Novartis, Sanofi, Sanofi-Aventis, and Teva. Andrea Surcinelli: received travel and meeting attendance support from Novartis, Biogen, Roche, Merck, Bristol, Sanofi-Genzyme, Almirall, and Piam. Guy Laureys: received travel and/or consultancy compensation from Sanofi-Genzyme, Roche, Teva, Merck, Novartis, Celgene, and Biogen. Sara Eichau: has received speaker honoraria and consultant fees from Biogen-Idec, Novartis, Merck, Janssen, Bristol-Myers, Bayer, Sanofi-Genzyme, Roche, and Teva. Pierre Duquette: served on editorial boards and has been supported to attend meetings by EMD, Biogen, Novartis, Genzyme, and TEVA Neuroscience. He holds grants from the CIHR and the MS Society of Canada and has received funding for investigator-initiated trials from Biogen, Novartis, and Genzyme. Suzanne Hodgkinson: has received consulting fees and speaker honoraria from Biogen, Novartis, Roche, and Merck, and has received grants for her institution from Biogen, Merck, Novartis, and Roche. Cristina Ramo-Tello: has received consulting fees, speaker honoraria, support for attending meetings and/or travel, participation on advisory boards, and research grants for her institution from Biogen, Novartis, Sanofi, Bristol, Roche, Almirall, Janssen, Sandoz, and Merck. Davide Maimone: received speaker honoraria for the advisory board and travel grants from Alexion, Almirall, Bayer, Biogen, Bristol Myers Squibb, Merck, Novartis, Roche, Sanofi-Genzyme, and Teva. Pamela McCombe: received speakers fees and travel grants from Novartis, Biogen, T’évalua, and Sanofi. Daniele Spitaleri: received honoraria as a consultant on scientific advisory boards by Bayer-Schering, Novartis, and Sanofi-Aventis, and compensation for travel from Novartis, Biogen, Sanofi-Aventis, Teva, and Merck. Jose Luis Sanchez-Menoyo: accepted travel compensation from Novartis, Merck, and Biogen; speaking honoraria from Biogen, Novartis, Sanofi, Merck, Almirall, Bayer, and Teva; and has participated in clinical trials by Biogen, Merck, and Roche. Seyed Mohammad Baghbanian: has served on scientific advisory boards and has received conference travel support and/or speaker honoraria from several pharmaceutical companies, including Roche, Novartis, Merck, Cinnagen, Nanoalvand, and Biogen. Rana Karabudak: received consulting fees, payment, or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events; support for attending meetings and/or travel; and participation on a data safety monitoring board or advisory board from Gen Turkey. Abdullah Al-Asmi: received personal compensation for serving as a scientific advisor or speaker/moderator for Novartis, Biogen, Roche, Sanofi-Genzyme, and Merck. Gregor Brecl Jakob: participated as a clinical investigator and/or received consultation and/or speaker fees from Amgen, Astra-Zeneca, Biogen, Janssen, Lek, Merck, Novartis, Pliva/Teva, Roche, Sanofi-Genzyme, and Swixx. Samia J. Khoury: received compensation for scientific advisory board activity from Merck and Roche, and received compensation for serving on the IDMC for Biogen. Vincent van Pesch: received travel grants from Merck Healthcare KGaA (Darmstadt, Germany), Biogen, Sanofi, Bristol Meyer Squibb, Almirall, and Roche. His institution has received research grants and consultancy fees from Roche, Biogen, Sanofi, Merck Healthcare KGaA (Darmstadt, Germany), Bristol Meyer Squibb, Janssen, Almirall, Novartis Pharma, and Alexion. Helmut Butzkueven: received institutional (Monash University) funding from Biogen, F. Hoffmann-La Roche Ltd, Merck, Alexion, CSL, and Novartis; has carried out contracted research for Novartis, Merck, F. Hoffmann-La Roche Ltd and Biogen; has taken part in speakers’ bureaus for Biogen, Genzyme, UCB, Novartis, F. Hoffmann-La Roche Ltd and Merck; has received personal compensation from Oxford Health Policy Forum for the Brain Health Steering Committee. Anneke van der Walt: served on advisory boards and receives unrestricted research grants from Novartis, Biogen, Merck and Roche She has received speaker’s honoraria and travel support from Novartis, Roche, and Merck. She receives grant support from the National Health and Medical Research Council of Australia and MS Research Australia. The remaining authors have nothing to declare.