N Mongay-Ochoa: had a predoctoral Rio Hortega fellowship, from the Instituto de Salud Carlos III (CM21/00018); has been awarded an ECTRIMS-MAGNIMS Research Fellowship for 2024; also received speaking honoraria and travel expenses from Merck and Roche. D Pareto: has received research support from Fondo de Investigaciones Sanitarias (PI18/00823, PI22/01709), co-funded by the European Union. P Ajdinaj: has nothing to disclose M Alberich: has nothing to disclose. M Tintoré: has received compensation for consulting services, speaking honoraria and research support from Almirall, Bayer Schering Pharma, Biogen-Idec, Genzyme, Janssen, Merck-Serono, Novartis, Roche, Sanofi-Aventis, Viela Bio and Teva Pharmaceuticals. Data Safety Monitoring Board for Parexel and UCB Biopharma X Montalbán: has received speaking honoraria and travel expenses for participation in scientific meetings, has been a steering committee member of clinical trials or participated in advisory boards of clinical trials in the past years with Abbvie, Actelion, Alexion, Biogen, Bristol-Myers Squibb/Celgene, EMD Serono, Genzyme, Hoffmann-La Roche, Immunic, Janssen Pharmaceuticals, Medday, Merck, Mylan, Nervgen, Novartis, Sandoz, Sanofi-Genzyme, Teva Pharmaceutical, TG Therapeutics, Excemed, MSIF and NMSS. À Rovira: serves/ed on scientific advisory boards for Novartis, Sanofi, Synthetic MR, Roche, and Biogen, and has received speaker honoraria from Bayer, Sanofi, Merck-Serono, Teva Pharmaceutical Industries Ltd, Novartis, Roche, Bristol-Myers and Biogen, is CMO and co-founder of TensorMedical. J Sastre-Garriga: serves as co-Editor for Europe & Africa on the editorial board of Multiple Sclerosis Journal and as Editor-in-Chief in Revista de Neurología, receives research support from Fondo de Investigaciones Sanitarias (19/950-22/750) and has served in the last 24 months as a consultant/speaker for BMS, Genzyme, Roche, Sanofi and Merck.

The study was conducted in accordance with the Declaration of Helsinki and was approved by the Local Ethics Committee, with the need for written informed consent waived.