Harding K, et al. - In this cohort study (n=592), researchers analyzed patients with multiple sclerosis for long-term outcomes of escalation vs early intensive disease-modifying therapy (DMT). They classified patients based on first-line treatment strategy: high-efficacy (early intensive treatment [EIT]) or moderate-efficacy DMT (escalation). According to findings, long-term outcomes following EIT vs first-line moderate-efficacy DMT were more favorable in a real-life setting. Contemporary surveillance strategies and protocols for escalation, however, might not be sufficiently responsive. This finding is particularly important because patients in real-world practice are typically selected for an EIT therapy approach based on clinical and radiological characteristics that predict poor outcomes.