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Ann Indian Acad Neurol. 2019 Jul-Sep;22(3):261-263. doi: 10.4103/aian.AIAN_159_19.

No Evidence of Disease Activity (NEDA) in Multiple Sclerosis - Shifting the Goal Posts.

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Professor of Neurology, Director of Center for Advanced Neurological Research, KS Hegde Medical Academy, Nitte (Deemed to be University), Mangalore, Karnataka, India.


A combined endpoint measure to define no evidence of disease activity (NEDA) is becoming increasingly appealing in the treatment of multiple sclerosis (MS). Initial efforts using a 3 parameter NEDA monitored disease activity using clinical and MRI lesion data. Later refinements, introduced more recently, include brain atrophy measurement and cognitive function analysis in defining NEDA-4. Using these stringent criteria clearly differentiated the usefulness of different disease modifying agents (DMDs) in achieving and sustaining NEDA over time. This in turn has changed attitudes and strategies in management of MS.


Multiple sclerosis; NEDA-3; NEDA-4

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