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Importantly, with time the majority of relapse-onset patients will transition to a clinically progressive course [known as secondary progressive MS (SPMS)] characterized by cytodegeneration, while the inflammatory component wanes with age (Compston and Coles, 2008)

Am J Obstet Gynecol 170: 14581466

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Meta-analyses were performed using random-effects models

The deciding factor is always the same: if the vial will be used once, sterile water is clean, simple, and sufficient its only when multi-dose use comes into play that bacteriostatic water becomes the necessary standard