Abstract: Multiple sclerosis (MS) is an autoimmune disorder of the central nervous system (CNS) and is primarily characterized by immune cell infiltration leading to relapses followed by remission phases and a disease course turning progressive over time with neurodegenerative processes taking over (Amin and Hersh, 2023). Of note, beyond relapse-associated worsening early in disease progression independent of relapse activity may arise independently of relapse activity and can occur in all phenotypes. Autoimmune-mediated damage of myelin sheaths and the subsequent loss of mature oligodendrocytes are resulting in impaired axonal integrity, neurodegeneration and accounts for irreversible neuronal damage (Kuhlmann et al., 2023). The current landscape of available disease-modifying therapies comprises mainly immunomodulatory drugs that effectively diminish relapses and slow down progression at the onset form of the disease, namely relapsing MS (RMS). In this regard, a number of drugs have been approved as disease-modifying therapies for MS by US Food and Drug Administration and European Medicines Agencies (Box 1).