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Predictive value of NEDA and brain atrophy in MS

 

REPORT FROM ECTRIMS – BARCELONA, SPAIN – OCTOBER 7-10, 2015 – A recent longitudinal study investigated whether MS patients with ongoing disease activity while on treatment had different clinical, radiological and neuropsychological outcomes at one year compared to those with no evidence of disease activity (NEDA), defined as no relapses, no three-month EDSS progression and no new MRI activity (Nygaard et al. PLoS One 2015;10:e0135974; free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC4539191/pdf/pone.0135974.pdf).

Overall, 46% of treated MS patients had evidence of disease activity and demonstrated EDSS progression (+0.4 points). In contrast, NEDA patients showed a slight improvement in EDSS scores (-0.3 points), which may be due to an absence of relapse-related short-term disability. Cognitive function was stable in both groups but patients with disease activity had a significantly higher rate of subcortical grey-matter (GM) atrophy compared to healthy controls. Read More

Too few patients considered candidates for treatment optimization

 

REPORT FROM ECTRIMS – BARCELONA, SPAIN – OCTOBER 7-10, 2015 – In 2007-2008, a retrospective analysis of over 9,000 patient records in Germany reported that about one-third of treated MS patients experienced one or more relapses in the preceding year and about 24% were candidates for treatment escalation according to clinical and radiological criteria (Maurer et al. Eur J Neurol 2011;18:1036-1045).

Since that time, the number of options for treatment optimization has expanded considerably, so a second study was performed in the period 2010-2014 (Schmidt et al. ECTRIMS 2015; abstract P294). Read More

Daclizumab: DECIDE trial update

 

REPORT FROM ECTRIMS – BARCELONA, SPAIN – OCTOBER 7-10, 2015 – DECIDE is the second phase III trial evaluating daclizumab, an anti-CD25 monoclonal antibody that modulates IL-2 signalling. Primary results were presented at the American Academy of Neurology annual meeting (Kappos et al. AAN 2015; abstract S4.003) but are not yet published. Subjects (mean age 36 years) were randomized to subcutaneous daclizumab 150 mg q4weeks or intramuscular interferon-beta-1a for 96-144 weeks.

The annualized relapse rate (ARR) was significantly lower with daclizumab versus IFNbeta (0.216 vs. 0.393). The risk of three-month confirmed disability progression was reduced 16% with daclizumab versus active control but did not achieve statistical significance. Read More