Dear Readers,

it is with pleasure that we present you with the next issue of the “MS Report” journal.

Author of the first paper, Lidia Darda-Ledzion, MD, PhD, from the Department of Neurology, Wolski Hospital, Warsaw, presents the currently proposed terminology related to the progression of multiple sclerosis in the individual clinical phenotypes of the disease, including the proposal to harmonize the definition of PIRA (active PIRA, clinical PIRA, true PIRA, PIRMA) and progression of multiple sclerosis, independent of relapse and disease activity. PIRA is believed to be an important factor which leads to patient disability, and its early diagnosis may improve long-term treatment results in multiple sclerosis patients.

In another article, Agnieszka Wencel-Warot, MD, PhD, representing the Clinical Department of Child and Adolescent Neurology, University Clinical Hospital, Poznan, discusses the practical guidelines on the treatment of multiple sclerosis in children. The author explains the principles behind escalation therapy with first and second-line immunomodulatory agents. She observes that the goal of treatment is to arrest disease activity, reduce cognitive deficits and inhibit progression of disability. It may be accomplished thanks to an early selection of high-efficacy drugs instead of the traditional escalation algorithm.

The following paper, prepared by Kamila Żur-Wyrozumska, MD, PhD, affiliated with the Center for Innovative Medical Education, Jagiellonian University, Krakow, explores the usefulness of the assessment of serum neurofilament (NfL) light chain levels. The author describes how the value of NfL concentration may impact the assessment of short-term disease activity and long-term progression risk. NfL measurements may also play an important part in the monitoring of therapy efficacy.

In the final paper of this issue, Elżbieta Jasińska, MD, PhD, representing the Collegium Medicum of the Jan Kochanowski University in Kielce as well as the Resmedica Neurology Clinic, presents a clinical case of an MS patient, who has experienced the SARS-CoV-2 infection, followed by a COVID-19 vaccination during her treatment with ofatumumab. The author demonstrates that patients who receive ofatumumab, a drug which causes lymphocyte B depletion, maintain an ability to synthesize antibodies and achieve their satisfactory levels, which leads to a milder course of infection.

Enjoy your reading!

prof. Dagmara Mirowska-Guzel, MD, PhD
Agnieszka Piechal, MD, PhD