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Inclusion of brain volume loss in a revised measure of 'no evidence of disease activity' (NEDA-4) in relapsing-remitting multiple sclerosis.


ABSTRACT: 'No evidence of disease activity' (NEDA), defined as absence of magnetic resonance imaging activity (T2 and/or gadolinium-enhanced T1 lesions), relapses and disability progression ('NEDA-3'), is used as a comprehensive measure of treatment response in relapsing multiple sclerosis (RMS), but is weighted towards inflammatory activity. Accelerated brain volume loss (BVL) occurs in RMS and is an objective measure of disease worsening and progression.To assess the contribution of individual components of NEDA-3 and the impact of adding BVL to NEDA-3 ('NEDA-4') METHODS: We analysed data pooled from two placebo-controlled phase 3 fingolimod trials in RMS and assessed NEDA-4 using different annual BVL mean rate thresholds (0.2%-1.2%).At 2?years, 31.0% (217/700) of patients receiving fingolimod 0.5?mg achieved NEDA-3 versus 9.9% (71/715) on placebo (odds ratio (OR) 4.07; p?

SUBMITTER: Kappos L 

PROVIDER: S-EPMC5015759 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Inclusion of brain volume loss in a revised measure of 'no evidence of disease activity' (NEDA-4) in relapsing-remitting multiple sclerosis.

Kappos Ludwig L   De Stefano Nicola N   Freedman Mark S MS   Cree Bruce Ac BA   Radue Ernst-Wilhelm EW   Sprenger Till T   Sormani Maria Pia MP   Smith Terence T   Häring Dieter A DA   Piani Meier Daniela D   Tomic Davorka D  

Multiple sclerosis (Houndmills, Basingstoke, England) 20151119 10


<h4>Background</h4>'No evidence of disease activity' (NEDA), defined as absence of magnetic resonance imaging activity (T2 and/or gadolinium-enhanced T1 lesions), relapses and disability progression ('NEDA-3'), is used as a comprehensive measure of treatment response in relapsing multiple sclerosis (RMS), but is weighted towards inflammatory activity. Accelerated brain volume loss (BVL) occurs in RMS and is an objective measure of disease worsening and progression.<h4>Objective</h4>To assess the  ...[more]

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