No Evidence of Disease Activity (NEDA) as a Clinical Assessment Tool for Multiple Sclerosis: Clinician and Patient Perspectives [Narrative Review]

Newsome, Scott D.; Binns, Cherie; Kaunzner, Ulrike W.; Morgan, Seth; Halper, June

doi:10.1007/s40120-023-00549-7

Cited by 6 publications

(2 citation statements)

References 147 publications

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“…Quality of life in MS patients is influenced by various factors including physical disability, cognitive function, and emotional well-being [ 13 , 14 ]. Previous studies have indicated that improvements in clinical and radiological measures of disease activity do not always correlate strongly with QoL improvements [ 15 , 16 ]. Moreover, the application of advanced MRI techniques in clinical practice has enhanced the understanding of MS pathophysiology and the monitoring of disease progression.…”

Section: Introductionmentioning

confidence: 99%

Impact of Ocrelizumab on Disease Progression, Memory Improvement, and Quality of Life in Patients with Relapsing-Remitting Multiple Sclerosis: A Longitudinal MRI and Clinical Criteria Analysis

Schuldesz,

Maganti,

Tudor

et al. 2024

Diseases

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Multiple sclerosis (MS) is a chronic, progressive neurological disorder that significantly impacts quality of life and functionality. Ocrelizumab, a monoclonal antibody targeting CD20-positive B cells, has emerged as a treatment for relapsing-remitting MS (RRMS). This study aimed to assess the impact of ocrelizumab on disease progression and quality of life over a longitudinal course, utilizing clinical criteria and magnetic resonance imaging (MRI) analyses. Conducted at the Neurology Department of Pius Brinzeu Clinical Emergency Hospital in Western Romania from 2020 to 2023, this observational study enrolled 93 patients with RRMS who commenced ocrelizumab therapy. The study employed the Expanded Disability Status Scale (EDSS) and MRI to evaluate disease progression, while quality of life was assessed using the World Health Organisation Quality of Life (WHOQOL) questionnaire, Beck Depression Index (BDI), and MOCA scales. Significant improvements were observed post-treatment. EDSS scores decreased from 4.61 to 4.08 (p = 0.038), indicating reduced disability. MRI analyses showed a substantial decrease in expansive lesions (from 67.74% to 26.88%, p < 0.001) and an increase in stationary lesions (from 32.26% to 73.12%, p < 0.001). Quality of life improvements were notable in the physical (from 58.42 to 64.84, p = 0.005) and environmental domains (from 63.21 to 68.44, p = 0.033). Cognitive functions, assessed via Montreal Cognitive Assessment (MOCA), showed a significant total score increase from 20.38 to 22.30 (p < 0.001). Subgroup analysis revealed more pronounced effects in females and younger patients, with a significant reduction in depressive symptoms measured by BDI scores (from 14.35 to 11.62, p = 0.003). Ocrelizumab significantly reduced disease activity and disability in RRMS patients, as demonstrated by improvements in EDSS scores and MRI findings. Quality of life and cognitive functions also showed considerable enhancements. These findings support ocrelizumab’s efficacy in not only managing MS symptoms but also improving overall patient well-being.

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Section: Introductionmentioning

confidence: 99%

Impact of Ocrelizumab on Disease Progression, Memory Improvement, and Quality of Life in Patients with Relapsing-Remitting Multiple Sclerosis: A Longitudinal MRI and Clinical Criteria Analysis

Schuldesz,

Maganti,

Tudor

et al. 2024

Diseases

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“…The treatment for MS is primarily concerned with the use of immunomodulating and immunosuppressive medications, which help reduce inflammation and limit disease progression; however, these agents often come with a risk of adverse reactions, including possible infections (Ghasemi et al., 2017 ). More recent disease modifying treatments have shown great promise in the treatment of the disease, with some even striving toward the outcome known as no evidence of disease activity, which is based on a demonstration of low clinical measures or lack of disease symptoms, relapses, progression, and MRI activity (Newsome et al., 2023 ). Yet, despite the present advancements, the symptoms of fatigue and lethargy that are experienced by those with MS stand as a crucial obstacle in the way of substantial improvement in the quality of life (QoL) for sufferers (Braley & Chervin, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

The use of modafinil for the treatment of fatigue in multiple sclerosis: A systematic review and meta‐analysis of controlled clinical trials

Ghazanfar,

Farooq,

Qazi

et al. 2024

Brain and Behavior

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IntroductionMultiple sclerosis (MS) is a debilitating neurological condition affecting nearly one million people across the United States. Among the most prominent symptoms of the condition are excessive fatigue and daytime sleepiness. Numerous clinical trials have investigated the efficacy of modafinil in addressing fatigue among these patients.ObjectiveThe objective of the present study is to assess the safety and efficacy of modafinil for the treatment of fatigue in MS.MethodologyAn electronic search of PUBMED, ScienceDirect, and Cochrane Central was conducted for articles published from inception to December 2023 using search terms such as “modafinil,” “fatigue,” and “MS.”ResultsSeven studies were included in our analysis. Modafinil leads to a meaningful reduction in fatigue when compared with placebo, as measured by Modified Fatigue Impact Scale [mean difference (MD) = −4.42 [−8.01, −.84]; I2 = 45%; p = .02] and Epworth Sleepiness Scale [MD = −.87 [−1.64, −.10]; I2 = 0%; p = .03]. Modafinil also demonstrated a greater risk of precipitating adverse events (e.g., insomnia, gastrointestinal symptoms) when compared with placebo [RR = 1.30 [1.03, 1.66]; I2 = 0%; p = .03]. In quality‐of‐life assessments, modafinil was associated with overall improvement in well‐being [standardized mean difference = .18 [.01, .35]; I2 = 56%; p = .04].ConclusionThe data indicates that modafinil confers a therapeutic benefit when treating fatigue in patients with MS and improves overall quality of life; however, there is a risk of precipitating adverse events. Ultimately, higher quality of evidence may be required to better inform clinical management.

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Predicting multiple sclerosis disease progression and outcomes with machine learning and MRI-based biomarkers: a review

Yousef,

Malagurski Tortei,

Castiglione

2024

J Neurol

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No Evidence of Disease Activity (NEDA) as a Clinical Assessment Tool for Multiple Sclerosis: Clinician and Patient Perspectives [Narrative Review]

Cited by 6 publications

References 147 publications

Impact of Ocrelizumab on Disease Progression, Memory Improvement, and Quality of Life in Patients with Relapsing-Remitting Multiple Sclerosis: A Longitudinal MRI and Clinical Criteria Analysis

Impact of Ocrelizumab on Disease Progression, Memory Improvement, and Quality of Life in Patients with Relapsing-Remitting Multiple Sclerosis: A Longitudinal MRI and Clinical Criteria Analysis

The use of modafinil for the treatment of fatigue in multiple sclerosis: A systematic review and meta‐analysis of controlled clinical trials

Predicting multiple sclerosis disease progression and outcomes with machine learning and MRI-based biomarkers: a review

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