AAN 2023 | Occurrence of PIRA in RRMS: current understanding

João José Cerqueira, MD, PhD, University of Minho, Braga, Portugal, discusses the presence of progression independent of relapse activity (PIRA) in relapsing-remitting multiple sclerosis (RRMS) patients. PIRA is most common in patients being treated with high-efficacy drugs that control relapses and inflammation. Currently, experts believe that PIRA may be driven by microglia and astrocytes, or due to compartmentalized inflammation resistant to drugs that target the periphery. This suggests that PIRA is a mixture of a real progression independent of activity as well as progression resistant to available drugs, highlighting an unmet need and area of improvement for MS treatments. This interview took place at the American Academy of Neurology Annual Meeting 2023 in Boston, MA.

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