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NEDA treatment target? No evident disease activity as an actionable outcome in practice
Ist Teil von
Journal of the neurological sciences, 2017-12, Vol.383, p.31-34
Ort / Verlag
Netherlands: Elsevier B.V
Erscheinungsjahr
2017
Link zum Volltext
Quelle
Elsevier ScienceDirect Journals Complete
Beschreibungen/Notizen
“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.
•NEDA-3 is defined as no relapses, disability progression, or MRI activity.•NEDA-4 also includes brain atrophy assessment as a marker of neurodegeneration.•NEDA is a potential sensitive outcome measure for therapeutic efficacy in clinical trials.•Early NEDA may not protect against long-term disability progression.•Observational studies will help determine whether NEDA has clinical merit.