…arget”, a term borrowed from rheumatology. The three requirements for treat-to-target are: to have a target; have a treatment that can hit the target; and have a way of determining if the target has been hit. Arguably, none of these criteria applies to MS (see Part 1 of this series), leaving the usefulness of this concept in question. A more practical approach to treatment planning is to initiate therapy with the most efficacious agent, with the v…

…87:134-140). Thus, one-third of patients who are seemingly stable – relapse-free and a low number of new lesions – during the first year on treatment would be expected to experience worsening disability over the next few years. A more stringent benchmark of treatment response is no evidence of disease activity (NEDA), defined as no relapses, no MRI activity and no EDSS change. Perhaps the most common objection is that this measure is not sustainab…