Multiple sclerosis (MS) is a chronic immune-mediated inflammatory disease of the brain and spinal cord that leads to demyelination and neurodegeneration. The diagnosis is based on the integration of the clinical presentation and paraclinical markers with the most important being the magnetic resonance imaging (MRI). The clinical, radiological and underlying pathology of MS is highly heterogeneous, therefore the effectiveness of disease-modifying treatments (DMT) differs in patients. As multiple therapies are becoming available, there is a lower threshold to accept any disease activity or worsening and the importance to create a surrogate marker to evaluate the efficacy of the DMT is rising. The model of “No evidence of disease activity” (NEDA) has been used as an outcome measure for treatment response. It is based on the absence of disease activity, which is defined, by the absence of clinical relapses, disability progression on EDSS, and radiological activity. Our aim was to extensively review the literature about the concept of NEDA and its different variants. We also reviewed the importance of its use as a surrogate marker to assess the efficacy of different DMTs.
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© 2019 Published by Elsevier Inc.