A Manouchehrinia, O Beiki et al. Table 3. Hazard of reaching EDSS score milestones 3.0, 4.0 and 6.0 and conversion to SPMS from birth, disease onset and MS diagnosis. Hazard ratio from birth (95% CI) EDSS score 3.0 Sex Female − Male 1.20 (1.11−1.30) Onset phenotype Bout onset − Progressive onset 1.12 (0.98−1.27) Province Götaland − Svealand 1.16 (1.07−1.25) Norrland 1.31 (1.17−1.46) EDSS score 4.0 Sex Female − Male 1.27 (1.16−1.39) Onset phenotype Bout onset − Progressive onset 1.28 (1.12−1.46) Province Götaland − Svealand 1.19 (1.09−1.30) Norrland 1.11 (0.97−1.28) EDSS score 6.0 Sex Female − Male 1.22 (1.11−1.33) Onset phenotype Bout onset − Progressive onset 1.46 (1.31−1.63) Province Götaland − Svealand 1.05 (0.96−1.14) Norrland 0.97 (0.85−1.11) Conversion to secondary progressive Sex Female − Male 1.24 (1.14−1.35) Province Götaland − Svealand 1.26 (1.16−1.37) Norrland 1.29 (1.14−1.47) Hazard ratio from disease onset (95% CI) Hazard ratio from diagnosis (95% CI) − 1.22 (1.12−1.32) − 1.18 (1.08−1.29) − 3.33 (2.92−3.79) − 3.62 (3.09−4.26) − 1.20 (1.11−1.30) 1.22 (1.08−1.37) − 1.25 (1.15−1.36) 1.21 (1.07−1.38) − 1.27 (1.15−1.39) − 1.27 (1.16−1.40) − 3.86 (3.37−4.41) − 4.69 (4.05−5.43) − 1.23 (1.13−1.35) 1.03 (0.89−1.18) − 1.31 (1.19−1.44) 1.12 (0.97−1.30) − 1.21 (1.11−1.32) − 1.25 (1.14−1.38) − 4.27 (3.82−4.77) − 4.66 (4.12−5.27) − 1.07 (0.98−1.16) 0.92 (0.80−1.05) − 1.11 (1.01−1.23) 0.97 (0.84−1.12) − 1.30 (1.20−1.41) − 1.34 (1.21−1.47) − 1.30 (1.19−1.41) 1.27 (1.12−1.44) − 1.40 (1.28−1.54) 1.23 (1.06−1.43) EDSS: Expanded Disability Status Scale; MS: multiple sclerosis; SPMS: secondary progressive multiple sclerosis; CI: confidence interval. Hazard ratio from one multivariate flexible parametric model. was longer than 27.9 years reported by Tremlett and colleagues,9 the categorised estimations based on onset phenotypes were strikingly similar (13.9 (95% journals.sagepub.com/home/msj CI: 12.6-14.8) vs 13.3 (95% CI: 11-15.5) in PPMS and 31.7 (95% CI: 30.5-32.6) vs 30.3 (95% CI: 28.6- 32) in bout-onset patients). Therefore, the difference 1493https://journals.sagepub.com/home/msj