Accepted for Publication: June 18, 2021.
Published Online: August 16, 2021. doi:10.1001/jamaneurol.2021.2738
Corresponding Author: Tim Spelman, PhD, MD, Department of Clinical Neuroscience, Karolinska Institute, Tomtebodavägen 18A, SE-171 77 Stockholm, Sweden (tim.spelman@ki.se).
Author Contributions: Dr Spelman had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Spelman, Magyari, Hillert, Lycke.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Spelman, Magyari, Lycke.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: Spelman.
Obtained funding: Piehl, Hillert, Lycke.
Administrative, technical, or material support: Magyari, Piehl, Sellebjerg, Lycke.
Supervision: Lycke.
Conflict of Interest Disclosures: Dr Spelman reported receiving compensation for serving on scientific advisory boards, honoraria for consultancy, and funding for travel from Biogen Inc; and speaker honoraria from Novartis. Dr Magyari reported receiving personal fees and grants from Biogen, Novartis, Merck, Sanofi, and Roche; personal fees from AbbVie, Alexion, and Bristol Myers Squibb; and grants from Teva outside the submitted work. Dr Piehl reported receiving grants from Swedish Medical Research Council and County of Stockholm during the conduct of the study; grants from Genzyme, Merck KGaA, UCB, Biogen, and Novartis; and personal fees from Parexel serving as chair of DMC in clinical trials outside the submitted work. Dr Rasmussen reported receiving personal fees from Novartis, Biogen, Alexion, Roche, Bristol Myers Squibb, Sanofi, and Merck outside the submitted work. Dr Sellebjerg reported receiving grants and personal fees from Biogen, Novartis, Merck, Roche, and Sanofi Genzyme; and personal fees from Bristol Myers Squibb and Alexion outside the submitted work. Ms Joensen reported receiving personal fees from Biogen outside the submitted work. Dr Hillert reported receiving grants and personal fees from Biogen, Celgene, Merck, Novartis, and Sanofi; grants from Roche; personal fees from Janssen, Bayer Schering, and Teva; funding from Swedish Research Council and the Swedish Brain Foundation; and serving as principal investigator for or receiving unrestricted research support from Biogen Idec, Merck Serono, TEVA, Sanofi Genzyme, and Bayer Schering outside the submitted work. Dr Lycke reported receiving grants from the Swedish Federal Government during the conduct of the study; personal fees from Biogen, Novartis, Merck, Alexion, Roche, Sanofi Genzyme, and BMS; and grants from Biogen and Novartis; and serving on the editorial board of the Acta Neurologica Scandinavica outside the submitted work. No other disclosures were reported.
Funding/Support: This study was supported by the Swedish Research Council, the Swedish Brain Foundation, the Karolinska University Hospital, the Patient-Centered Outcomes Research Institute, the Swedish Multiple Sclerosis Research Foundation, the Swedish Federal Government (LUA/ALF Agreement ALFGBG-722081), the Swedish Association of Persons with Neurological Disabilities, the Research Foundation of the Multiple Sclerosis Society of Gothenburg, the Edith Jacobson Foundation, and NEURO Sweden.
Role of the Funder/Sponsor: The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.