Harding K, et al. - In this cohort study with 592 individuals, researchers analyzed patients with multiple sclerosis for long-term outcomes after an escalation tactic vs early intensive disease-modifying therapy (DMT). Patients were categorized as either high-efficacy (early intensive treatment [EIT]) or moderate- efficacy DMT (escalation [ESC]) according to the first-line treatment strategy. After early intensive therapy vs first-line moderate-efficacy DMT, long-term outcomes were more favorable in a real-life setting. Modern monitoring strategies and protocols for escalation may not be responsive enough. This finding is especially pertinent as patients are typically selected for an EIT therapy approach based on clinical and radiological characteristics that predict poor outcome in real-world practice.