NEDA treatment target? No evident disease activity as an actionable outcome in practice

Natalie E Parks; Eoin P Flanagan; Claudia F Lucchinetti; Dean M Wingerchuk

doi:10.1016/j.jns.2017.10.015

NEDA treatment target? No evident disease activity as an actionable outcome in practice

J Neurol Sci. 2017 Dec 15:383:31-34. doi: 10.1016/j.jns.2017.10.015. Epub 2017 Oct 13.

Authors

Natalie E Parks¹, Eoin P Flanagan², Claudia F Lucchinetti³, Dean M Wingerchuk⁴

Affiliations

¹ Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA; Division of Neurology, Dalhousie University, 1341 Summer Street, Halifax, NS B3H4K4, Canada. Electronic address: nparks@dal.ca.
² Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Electronic address: flanagan.eoin@mayo.edu.
³ Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Electronic address: clucchinetti@mayo.edu.
⁴ Department of Neurology, Mayo Clinic, 13400 E Shea Boulevard, Scottsdale, AZ 85259, USA. Electronic address: wingerchuk.dean@mayo.edu.

PMID: 29246616
DOI: 10.1016/j.jns.2017.10.015

Abstract

"No evident disease activity" (NEDA) is a proposed measure of disease activity-free status in multiple sclerosis (MS) that is typically defined as absence of relapses, disability progression, and MRI activity over a defined time period. NEDA is increasingly reported in randomized controlled trials of MS disease modifying therapies where it has some perceived advantages over outcomes such as annualized relapse rate. NEDA has also been proposed as a treatment goal in clinical care. At this point, the long-term implications of early NEDA remain largely unknown. We review current NEDA definitions, use in clinical trials, and its prospects for routine use as an actionable treatment target in clinical practice.

Keywords: Disease modifying therapy; Multiple sclerosis; No evident disease activity; Outcome measures; Treatment target.

Publication types

Review

MeSH terms

Disease-Free Survival*
Humans
Multiple Sclerosis / diagnosis*
Multiple Sclerosis / physiopathology
Multiple Sclerosis / therapy*
Observational Studies as Topic
Randomized Controlled Trials as Topic