Trajectories of disease-modifying therapies and associated sickness absence and disability pension among 1923 people with multiple sclerosis in Sweden

•Four disease modifying therapies (DMTs) use trajectories over 10 years were identified in a large sample of people with multiple sclerosis (PwMS) including long-term non-high-efficacy DMTs (39.2%), escalation to high-efficacy DMTs (31.2%), delayed start and escalation to high-efficacy DMTs (15.4%) and discontinued/ no DMT (14.2%).•Age, MS type, expanded disability status scale score, and the number of DMT switches were associated with cluster belonging.•PwMS belonging to the long-term non-high efficacy DMTs trajectory had fewer sickness absence and disability pension days towards the last year of the follow-up.