Spelman T, Magyari M, Piehl F, et al. - A cohort study examining clinical outcomes in relapsing-remitting multiple sclerosis (RRMS) in correlation to national differences in disease-modifying treatment (DMT) strategies.

• Patients in the Danish and Swedish multiple sclerosis registries were compared.

• From the Swedish MS registry and the Danish MS registry, a total of 2,700 patients (1,867 women [69.2%]; mean [SD] age, 36.1 [9.5] years) and 2,161 patients (1472 women [68.1%]; mean [SD] age, 37.3 [9.4 years]), who started a first DMT between 2013 and 2016 were included in this analysis, respectively.

• The Swedish cohort used highly effective disease-modifying treatment far more frequently, which was linked with significant reductions in the rate of confirmed disability worsening and relapse outcomes.

• Overall findings suggest inferiority of escalation of treatment to using a more effective disease-modifying treatment as initial treatment for multiple sclerosis.