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ONCE SPARKED, SMOULDERING 
NEUROINFLAMMATION IS DESTRUCTIVE1,2

Starting at the onset of multiple sclerosis (MS), smouldering neuroinflammation continues to cause damage, which can manifest over time as gradual disability accumulation.3-5

Learn about the evidence
Illustration of a brain

Acute & Smouldering Neuroinflammation

Examine evidence for 2 neuroinflammatory processes driving disability accumulation from the onset of MS3-5

Explore both processes
Illustration of a woman being pulled back by a heavy weight

Disability Accumulation

Learn more about the physical and cognitive changes that may appear early in the disease process6-8

Understand the signs
Illustration of two arrows crossing over each other

Considering Both Processes

Explore the importance of understanding both smouldering and acute neuroinflammation in MS

Discover the new perspective

Smouldering Stories

Hear how smouldering neuroinflammation may impact the life of Marissa, a patient with MS.


 

Hear more patient stories

References:

  1. Cree BAC, Hollenbach JA, Bove R, et al; University of California, San Francisco MS-Epic Team. Silent progression in disease activity-free relapsing multiple sclerosis. Ann Neurol. 2019;85(5):653-666.
  2. Ziemssen T, Derfuss T, de Stefano N, et al. Optimizing treatment success in multiple sclerosis. J Neurol. 2016;263(6):1053-1065.
  3. Frisch ES, Pretzsch R, Weber MS. A milestone in multiple sclerosis therapy: monoclonal antibodies against CD20—yet progress continues. Neurotherapeutics. 2021;18(3):1602-1622.
  4. Giovannoni G, Popescu V, Wuerfel J, et al. Smouldering multiple sclerosis: the ‘real MS’. Ther Adv Neurol Disord. 2022;15:1-18. doi:10.1177/17562864211066751
  5. Häusser-Kinzel S, Weber MS. The role of B cells and antibodies in multiple sclerosis, neuromyelitis optica, and related disorders. Front Immunol. 2019;10:201. doi:10.3389/fimmu.2019.00201
  6. Bayas A, Schuh K, Christ M. Self-assessment of people with relapsing-remitting and progressive multiple sclerosis towards burden of disease, progression, and treatment utilization results of a large-scale cross-sectional online survey (MS Perspectives). Mult Scler Relat Disord. 2022;68:104166. doi:10.1016/j.msard.2022.104166
  7. Portaccio E, Bellinvia A, Fonderico M, et al. Progression is independent of relapse activity in early multiple sclerosis: a real-life cohort study. Brain. 2022;145(8):2796-2805.
  8. Lakin L, Davis BE, Binns CC, Currie KM, Rensel MR. Comprehensive approach to management of multiple sclerosis: addressing invisible symptoms—a narrative review. Neurol Ther. 2021;10(1):75-98.

MAT-XU-2500897 v1.0 May 2025