“We are at war.” This is how French President Emmanuel Macron addressed the nation in March 2020. He was then referring to the pandemic that has caused so many casualties and affected individuals and societies around the world. As we continue to anxiously monitor waves of SARS-CoV-2 variants, a new armed conflict is displacing millions of Ukrainians. There were an estimated 20,000 people living with multiple sclerosis (MS) in Ukraine in 2016, and we know that their ability to get the care they need is adversely affected by this conflict. Our thoughts and prayers go to them and to their loved ones.

The Consortium of Multiple Sclerosis Centers’ annual meeting will open in Washington DC on June 1, 2022, 2 days after World MS Day. If you plan to attend the conference, please stop by the International Journal of MS Care (IJMSC) booth in the exhibit hall and meet the editorial team, as well as our new publisher, MJH Life Sciences®. Two awards will be presented during the annual meeting: the Herndon Award for Outstanding IJMSC Article, in honor of our founding editor Robert Herndon, MD, which will recognize the best article published in 2021; and the Promise Award for Best Young Investigator Article, in honor of the late Lael Stone, MD, our second editor, which will recognize the best article first-authored by a young investigator.

The current issue of IJMSC features a CE article by Hartung and colleagues on the use of prescription drugs in Medicare beneficiaries in the United States. In addition to reminding us of the significant out of pocket costs related to disease-modifying therapies (DMTs), this study highlights the commonly prescribed medications to treat symptoms and comorbidities associated with MS. While the out of pocket costs for these drugs isn’t as elevated compared with DMTs, it does add to the financial burden of the disease and invites a discussion about the risks associated with polytherapy.

These concerns underscore the need for research on nonpharmacological management of consequences of MS, such as the effect of technology-facilitated physical rehabilitation on depressive symptoms, as investigated by Kane and colleagues, or the impact of an app-facilitated behavioral intervention to enhance conscientiousness developed by Fuchs and colleagues.

Walking is more onerous to people with MS than to healthy individuals, in terms of oxygen cost. This finding is highlighted by a literature review (Rooney and colleagues) and a cross-sectional study (Manca and colleagues). Other questions about the oxygen cost of walking raised in these articles, such as its relationship with fatigue and the impact of sex, need to be further explored.

Bowel dysfunction, while highly prevalent in MS, is seldom addressed in scholarly publications. It is therefore notable that this issue features 2 research articles on this topic. Urology specialists Van Doorn and colleagues propose elements of validation for the Dutch version of the Neurogenic Bowel Dysfunction score. Woodward and colleagues ask a provocative question (“Whose job is it anyway?”) to introduce their report on feedback from healthcare professionals on the care pathway for bowel dysfunction. This question could be asked in relation to many consequences of MS, as the coordination of patient-centered multidisciplinary management is a difficult task, as much influenced by evidence and guidelines as by individual preferences and contextual factors.

Let’s keep the discussion going. We invite our readers and contributors to stay in touch with us, possibly in person in June at the CMSC annual meeting or through social media at any time.