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Interview with Ludwig Kappos: Predictive value of NEDA for disease outcome over 6 years in patients with RRMS

Kappos NEDA 4-HD

According to Professor Kappos, there was an increasing need to have a comprehensive summarising outcome when comparing different clinical trials. One possibility was to use NEDA (no evidence for disease activity), which means no relapses confirmed, no disability progression, and no new lesions in MRI scans (T2 weighted unenhanced scans or Gd contrast enhanced scans). 

Professor Kappos reported that NEDA (up to NEDA 3) has been increasingly used in recent years but had some deficiencies; it was very highly weighted in the direction of disease activity, especially MRI activity. Last year NEDA 4 was proposed, which included the result of brain volume loss.

Professor Kappos and his colleagues had now analysed data from 2 placebo controls, with the aim of comparing the predictive values of NEDA 3 and NEDA 4 for outcomes at 5, 6 or 7 years. It was found that NEDA 3 was predictive for relapse activity, but that NEDA 4 was somewhat more predictive of disability outcome or more permanent tissue damage. Further assessment is needed to assess the prognostic value of NEDA 4.

Dr. Kappos is Professor of Neurology at Basel University Hospital, Switzerland. 

This interview has been recorded at ECTRIMS 2015, October 2015, Barcelona, Spain.