Journal Article

Assessing ‘No Evidence of Disease Activity’ Status in Patients with Relapsing-Remitting Multiple Sclerosis Receiving Fingolimod in Routine Clinical Practice: A Retrospective Analysis of the Multiple Sclerosis Clinical and Magnetic Resonance Imaging Outcomes in the USA (MS-MRIUS) Study

Silversteen, Jason, Zivadinov, Robert, Silva, Diego, Weinstock-Guttman, Bianca, Lathi, Ellen, Medin, Jennie, Khan, Nasreen, Calkwood, Jonathan, Korn, Jonathan R.

2018

Overview

Background ‘No evidence of disease activity’ (NEDA), a composite measure of clinical and magnetic resonance imaging outcomes, provides a comprehensive assessment of disease activity, but is not extensively reported in clinical practice. NEDA-3 is defined as patients with no new/enlarged T2 or gadolinium-enhancing lesions, no relapses, and no disability progression (according to Expanded Disability Status Scale scores). NEDA-4 comprises the components of NEDA-3 and a fourth criterion of ≤ 0.4% annualized brain volume loss. Objective The objective of this study was to assess NEDA status among patients with relapsing-remitting multiple sclerosis receiving fingolimod in clinical practice. Methods Clinical and magnetic resonance imaging data were retrospectively collected from 590 patients who initiated fingolimod at 33 multiple sclerosis centers in the USA. Patients were required to have a magnetic resonance imaging scan in the 6 months before or 1 month after fingolimod initiation (index period) and in the 9–24 months after fingolimod initiation (post-index period). Magnetic resonance imaging data were systematically quantified at a centralized reading facility. The proportions of patients with NEDA-3 or NEDA-4 status during fingolimod treatment were assessed. Results During the follow-up period (median: 16 months), data to assess NEDA-3 and NEDA-4 were available for 586 and 325 patients, respectively. In the post-index period, 58.7% of patients achieved NEDA-3 status (no relapses, 85.2%; no new/enlarged T2/gadolinium-enhancing lesions, 76.3%; no disability progression, 87.9%) and 37.2% achieved NEDA-4 status (no relapses, 86.5%; no new/enlarged T2/gadolinium-enhancing lesions, 78.8%; no disability progression, 91.1%; brain volume loss ≤ 0.4, 58.2%). Conclusion Among patients receiving fingolimod, over half achieved NEDA-3 status and over one-third achieved NEDA-4 status.

• Publisher: Springer International Publishing,Springer Nature B.V
• Subject: Adult / Atrophy / Clinical medicine / Clinical trials / Cohort Studies / Disease Progression / Female / Fingolimod Hydrochloride - therapeutic use / Follow-Up Studies / Gadolinium / Humans / Immunosuppressive Agents - therapeutic use / Interferon / Longitudinal Studies / Magnetic resonance imaging / Magnetic Resonance Imaging - methods / Male / Medicine / Medicine & Public Health / Middle Aged / Multiple sclerosis / Multiple Sclerosis, Relapsing-Remitting - diagnostic imaging / Multiple Sclerosis, Relapsing-Remitting - drug therapy / Multiple Sclerosis, Relapsing-Remitting - physiopathology / Neuroimaging / Neurology / Neurosciences / NMR / Nuclear magnetic resonance / Original / Original Research Article / Patients / Pharmacotherapy / Psychiatry / Psychopharmacology / Retrospective Studies / Studies / Treatment Outcome / Young Adult