ReviewEuropean journal of neurology2018
'No evidence of disease activity' - is it an appropriate surrogate in multiple sclerosis?
Review in European journal of neurology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 78 citations in OpenAlex.
- Adult and pediatric relapsing multiple sclerosis phase II and phase III trial design and their primary end points: A systematic review.Clinical and translational science · 2024Pooled it
- E-based physical exercise in patients with multiple sclerosis and comorbidity (COMPACT): feasibility study and protocol for a randomized controlled trial.Frontiers in immunology · 2026Trial
- Consensus Definitions of Disease Activity and Clinical Outcomes in Patients With Chronic Inflammatory Demyelinating Polyradiculoneuropathy.Neurology · 2026Article
- Integration of retinal layer thinning into NEDA-3 predicts disability progression in multiple sclerosis.Journal of neurology · 2026Observational
- Bayes at the Bedside: Biomarkers in Situations of Clinical Uncertainty.Diagnostics (Basel, Switzerland) · 2026Article
- Refining predictors of long-term NEDA-3 status in relapsing-remitting multiple sclerosis: insights from real-world data.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Real-World Comparison of High-Efficacy Versus Non-High-Efficacy Therapies in Multiple Sclerosis.Annals of clinical and translational neurology · 2025Observational
- Real-World Data of First 12-Months of Ofatumumab Treatment in Multiple Sclerosis Patients-A Multicenter Experience from Tertiary Referral Centers.Medicina (Kaunas, Lithuania) · 2025Observational
- Retinal thinning differentiates treatment effects in relapsing multiple sclerosis below the clinical threshold.Annals of clinical and translational neurology · 2025Observational
- Effect of autoimmune comorbidities on multiple sclerosis course: An observational multicenter study.European journal of neurology · 2025Observational
- Predicting multiple sclerosis disease progression and outcomes with machine learning and MRI-based biomarkers: a review.Journal of neurology · 2024Review
- Peering further into the mind's eye: combining visual evoked potential and optical coherence tomography measures enhances insight into the variance in cognitive functioning in multiple sclerosis.Journal of neurology · 2024Article
- The global patient-reported outcomes for multiple sclerosis initiative: bridging the gap between clinical research and care - updates at the 2023 plenary event.Frontiers in neurology · 2024Review
- No Evidence of Disease Activity (NEDA) as a Clinical Assessment Tool for Multiple Sclerosis: Clinician and Patient Perspectives [Narrative Review].Neurology and therapy · 2023Review
- Effectiveness of teriflunomide on No Evidence of Disease Activity and cognition in relapsing remitting multiple sclerosis: results of the NEDA3PLUS study.Journal of neurology · 2023Observational
- Article
- New Contrast Enhancement Method for Multiple Sclerosis Lesion Detection.Journal of digital imaging · 2023Article
- Predictive value of brain atrophy, serum biomarkers and information processing speed for early disease progression in multiple sclerosis.Frontiers in neurology · 2023Article
- Retinal Layer Thinning After Optic Neuritis Is Associated With Future Relapse Remission in Relapsing Multiple Sclerosis.Neurology · 2022Observational
- Long-term outcome after COVID-19 infection in multiple sclerosis: a nation-wide multicenter matched-control study.European journal of neurology · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The increasing number of disease-modifying treatments available for multiple sclerosis has broadened treatment options for patients, but also challenges clinicians to select the best therapy for each individual at the appropriate stage of the disease. Early prediction of treatment response still remains one of the main difficulties in the management of multiple sclerosis patients. The concept of 'no evidence of disease activity' (NEDA) has been proposed as a surrogate for treatment response based on the absence of relapses, disability progression and radiological activity. Although there are several apparently logical arguments for the NEDA approach, there are also some major concerns that have to be considered and that are not sufficiently addressed yet. Amongst others, each parameter's limitations are not eliminated solely by its use within a composite score, and the contribution of each parameter to NEDA is not well balanced, as the detection of, for example, a single new magnetic resonance imaging lesion is considered as significant as the occurrence of a severely disabling relapse. NEDA in its current form also neglects underlying pathophysiology of the disease, has not been shown to fulfil formal criteria of a surrogate marker and its prognostic value has not been sufficiently evidenced yet. From a clinical point of view, 'evidence of disease activity' seems the more relevant surrogate; however, its implications are even less clear than those of NEDA. Here, existing literature on NEDA is critically reviewed and improvements are discussed that value its potential use in clinical trials and, even more importantly, treatment decision making in daily routine.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.