ReviewJournal of neurology2024
Identification and management of subclinical disease activity in early multiple sclerosis: a review.
Review in Journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 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
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Relapse prediction and individualized treatment-effect modeling in relapsing multiple sclerosis: a systematic review.Frontiers in public health · 2026Pooled it
- Efficacy and safety of ofatumumab in participants with relapsing multiple sclerosis and breakthrough disease on oral fingolimod or fumarates: results from the ARTIOS study.Journal of neurology · 2026Trial
- Results of a pilot randomized controlled trial of a COM-B-based physical activity behavior-change intervention in people newly diagnosed with multiple sclerosis.Multiple sclerosis and related disorders · 2026Trial
- Article
- Beyond MRI surveillance in radiologically isolated syndrome: the emerging role of VR/AR neurotechnology for subclinical progression.Annals of medicine and surgery (2012) · 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
- Serum miRNA-155 and TREM2 as Non-Invasive Biomarkers for Monitoring Neuroinflammation and Disease Activity in Multiple Sclerosis.Molecular neurobiology · 2026Review
- Cognitive function is associated with risk of conversion to secondary progressive multiple sclerosis: A cross-sectional study.PloS one · 2026Article
- Deep Learning Approaches for Multiple Sclerosis Detection in MRI Images.BioMed research international · 2026Article
- Multiple sclerosis from onset to secondary progression: a 30-year Italian register study.Journal of neurology, neurosurgery, and psychiatry · 2025Article
- Theory-based physical activity behavior change intervention in people newly diagnosed with multiple sclerosis: Study protocol for a pilot randomized controlled trial.Contemporary clinical trials · 2025Article
- Gait instability is a more specific predictor of corticospinal tract function than gait speed in clinically stable multiple sclerosis.Scientific reports · 2025Article
- Balo Concentric Sclerosis: A Rare Variant of Multiple Sclerosis With Excellent Response to Early Steroid Treatment.Cureus · 2025Article
- Clinical and paraclinical features distinguish fatigue from depression-predominant phenotypes in multiple sclerosis.Scientific reports · 2025Observational
- The role of Neurofilament light (NfL) and glial fibrillary acidic protein (GFAP) in MS and AQP4-NMOSD: Advancing clinical applications.eNeurologicalSci · 2025Review
- Current challenges in secondary progressive multiple sclerosis: diagnosis, activity detection and treatment.Frontiers in immunology · 2025Review
- Organisational impact and patient management models for biomarker integration in multiple sclerosis care in Italy: the 0Tolerance project.BMJ neurology open · 2025Article
- SynSpine: an automated workflow for the generation of longitudinal spinal cord synthetic MRI data.Frontiers in neuroinformatics · 2025Article
- Robotic Rigor: Validity of the Kinarm End-Point Robot Visually Guided Reaching Test in Multiple Sclerosis.Archives of rehabilitation research and clinical translation · 2024Article
- Advanced MRI Techniques: Diagnosis and Follow-Up of Multiple Sclerosis.Diagnostics (Basel, Switzerland) · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
importanceEarly treatment initiation in multiple sclerosis (MS) is crucial in preventing irreversible neurological damage and disability progression. The current assessment of disease activity relies on relapse rates and magnetic resonance imaging (MRI) lesion activity, but inclusion of other early, often "hidden," indicators of disease activity may describe a more comprehensive picture of MS. OBSERVATIONS: Early indicators of MS disease activity other than relapses and MRI activity, such as cognitive impairment, brain atrophy, and fatigue, are not typically captured by routine disease monitoring. Furthermore, silent progression (neurological decline not clearly captured by standard methods) may occur undetected by relapse and MRI lesion activity monitoring. Consequently, patients considered to have no disease activity actually may have worsening disease, suggesting a need to revise MS management strategies with respect to timely initiation and escalation of disease-modifying therapy (DMT). Traditionally, first-line MS treatment starts with low- or moderate-efficacy therapies, before escalating to high-efficacy therapies (HETs) after evidence of breakthrough disease activity. However, multiple observational studies have shown that early initiation of HETs can prevent or reduce disability progression. Ongoing randomized clinical trials are comparing escalation and early HET approaches. CONCLUSIONS AND RELEVANCE: There is an urgent need to reassess how MS disease activity and worsening are measured. A greater awareness of "hidden" indicators, potentially combined with biomarkers to reveal silent disease activity and neurodegeneration underlying MS, would provide a more complete picture of MS and allow for timely therapeutic intervention with HET or switching DMTs to address suboptimal treatment responses.
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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.