Immunomodulator drugs have shown effectiveness for what? (Select all that apply. One, some, or all)

A. Immunomodulators have not shown significant effectiveness for primary progressive multiple sclerosis (MS). This type of MS progresses steadily without clear relapses, and current immunomodulatory drugs do not significantly alter disease progression in these patients. B. Immunomodulators can be used in secondary progressive MS, particularly in patients who still experience relapses. While the effect is less dramatic than in relapsing forms, some benefit in reducing relapse frequency and slowing progression may occur. C. Immunomodulators do not prevent the development of MS in at-risk populations. Their use is therapeutic after diagnosis to manage disease activity, not preventive. D. Immunomodulators are most effective in relapsing-remitting MS, where they reduce the frequency and severity of relapses, decrease MRI lesion formation, and can delay disability progression. Drugs like interferon beta and glatiramer acetate are standard therapies in this form. E. Progressive-relapsing MS is rare, and immunomodulators may be helpful in managing the relapsing component of this disease. They can reduce the frequency of relapses even if the progressive component continues.