Multiple Sclerosis as a Continuously Progressive Disease

At European Charcot Foundation 2025, Gavin Giovannoni, MD, Professor of Neurology at Queen Mary University of London, discussed the view that multiple sclerosis (MS) is a single disease with progression present from the outset. He questioned the traditional MS subtypes and reviewed evidence showing that disability progression can occur independently of relapses, including in early stages. Drawing on data on PIRA and brain volume loss, he described “smouldering MS” as an ongoing underlying process and noted the potential importance of early, effective treatment.