NEDA, treat-2-target and Las Vegas

T2T of NEDA; the emerging treatment paradigm to manage MS. #MSBlog #MSResearch

“The following is the agenda for the MS Experts Consensus Summit on NEDA (No Evident Disease Activity) as a treatment target in MS. This is the second meeting that is being hosted by Rick Rudick and colleagues from the Cleveland Clinic. You may recall helping me out with a survey in September last year when I spoke at the first meeting in Cleveland, Ohio.”

“NEDA is a topic close to my heart. All the evidence points to this being the big paradigm shift in the treatment of MS. My so called ZeTo or zero tolerance strategy of treating MS actively with the aim of suppressing all inflammation as soon as possible in the course of the disease. The underlying principles is preventative healthcare; by preventing damage you can delay or prevent the onset of progressive MS and to maintain the brain and spinal cord in an as healthy state as possible to allow MSers the opportunity of healthy ageing. At the conclusion of my talk at the Cleveland meeting I proposed several questions that I will be addressing superficially in my talk to day. I have added two additional questions to my list from September 2012 about what needs to be done to communicate this paradigm shift and what needs to bed done to facilitate the adoption of this treatment strategy.”

  1. What should NEDA look like? 
  2. Should the definition be stage specific? 
  3. What do we do about post-inflammatory neurodegeneraton? 
  4. What about the potential effects of superimposed accelerated , or premature, aging? 
  5. How do we define an appropriate baseline for comparison? 
  6. How do we deal with the difference between maintenance and induction therapies? 
  7. How do we standardise (or improve) on the metrics? 
  8. How do we communicate these concepts to our colleagues and more importantly MSers? 
  9. How can we facilitate the adoption of the T2T-NEDA paradigm?

12 Feb 2013
At present NEDA is defined using a composite of a) no relapses, or b) no EDSS progression, or c) no MRI activity (new or enlarging T2 lesions or no Gd-enhancing lesions) (Havrdova, Galetta et al. 2009; Giovannoni, Cook et al. 2011). This description is currently based on data that is routinely collected in …… Prof G,Will you be attending the NEDA meeting in Cleveland?Why do MS patients get such a poor deal? Surely, the aim of any treatment (for any… Continue >>.
08 Jan 2013
The idea is to adopt the strategy of treating-2-target; the target being NEDA or no evidence of disease activity. This approach has being …… Prof G,Will you be attending the NEDA meeting in Cleveland?Why do MS patients get 
23 Sep 2012
I am about to travel to the Cleveland Clinic, in Ohio, to attend a meeting on “Freedom from MS Disease Activity”; a subject that is very close to my heart. …… Prof G,Will you be attending the NEDA meeting in Cleveland?Why do 

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

1 comment

  • I would just like to use this blog for complaining about the name NEDA. While the concept is big advance, the name is misleading. Currently to have MS means (by McDonalds) to have demyelinating lesions already formed. Instead NEDA measures the formation of new ones. A better name would be "No Evidence of UNDERLYING Disease Activity", whatever the underlying disease is.

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