Can clinicians identify MS progression as it happens, or does confirming meaningful disability worsening require months of observation?

Early recognition of multiple sclerosis (MS) progression is critical to informing clinical decisions. Yet distinguishing genuine disease progression from temporary fluctuations remains one of the challenges in routine MS care.

In this episode of the ECTRIMS Podcast, produced in collaboration with the Multiple Sclerosis Journal, host Associate Professor Anneke van der Walt is joined by Professor Helmut Butzkueven (Monash University, Australia) and Professor Tjalf Ziemssen (University Hospital Dresden, Germany) to explore both sides of a timely clinical controversy: Can we detect a progression event in an MS clinic in real time?

Drawing on opposing perspectives published in the Multiple Sclerosis Journal, the discussion examines the value and limitations of disability assessments, longitudinal patient registries, digital monitoring tools and patient-reported changes.

Can routinely collected clinical data help clinicians recognise progression earlier? How reliable are current measures such as the Expanded Disability Status Scale (EDSS)? And what can clinicians do to identify meaningful change when consultation time and resources are limited?

The conversation highlights the importance of balancing early recognition with diagnostic certainty, while keeping the patient's lived experience central to clinical assessment.

Read the accompanying publications in the Multiple Sclerosis Journal:

• YES – Can we detect a progression event in an MS clinic in real time? https://journals.sagepub.com/doi/full/10.1177/13524585251409568
• NO – Can we detect a progression event in an MS clinic in real time?https://journals.sagepub.com/doi/full/10.1177/13524585251409547
• Accompanying commentary https://journals.sagepub.com/doi/full/10.1177/13524585251409579

This ECTRIMS podcast episode is supported by an educational grant from Alexion, AstraZeneca Rare Diseases. Bristol Myers Squibb, Novartis, Roche, Sanofi, and UCB. Educational grant providers have no input into the podcast series content.