Population-based study of "no evident disease activity" in MS

Natalie E. Parks; Sean J. Pittock; Jay Mandrekar; Orhun H. Kantarci; Claudia F. Lucchinetti; Brian G. Weinshenker; B. Mark Keegan; W. Oliver Tobin; Jan Mendelt Tillema; Michel Toledano; Eoin P. Flanagan

doi:10.1212/NXI.0000000000000495

Population-based study of "no evident disease activity" in MS

Natalie E. Parks, Sean J. Pittock, Jay Mandrekar, Orhun H. Kantarci, Claudia F. Lucchinetti, Brian G. Weinshenker, B. Mark Keegan, W. Oliver Tobin, Jan Mendelt Tillema, Michel Toledano, Eoin P. Flanagan

Medicine

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Resumen

Objective To determine the persistence of no evident disease activity (NEDA) in a population-based relapsing-remitting MS (RRMS) cohort. Methods All incident cases of RRMS in Olmsted County between 2000 and 2011 were identified using a medical records linkage system. Persistence of NEDA after RRMS diagnosis was determined by retrospective chart review. MRI activity, relapse, or Expanded Disability Status Scale (EDSS) worsening resulted in failure of NEDA. Results We identified 93 incident cases of RRMS including 82 individuals with sufficient follow-up to determine the persistence of NEDA. There were 44 individuals not on disease-modifying therapy (DMT), whereas 37 individuals were prescribed an injectable DMT and 1 received mitoxantrone during the interval over which NEDA was maintained. NEDA was maintained by 63% at 1 year, 38% at 2 years, 19% at 5 years, and 12% at 10 years according to routine care assessment. At 10 years, there was no difference in EDSS disability among patients who maintained NEDA vs those who failed NEDA at 1 year (p = 0.3). Conclusions NEDA infrequently persists beyond 2 years in a population-based cohort of newly diagnosed patients with RRMS.

Idioma original	English
Número de artículo	e495
Publicación	Neurology: Neuroimmunology and NeuroInflammation
Volumen	5
N.º	6
DOI	https://doi.org/10.1212/NXI.0000000000000495
Estado	Published - nov. 1 2018

Nota bibliográfica

Funding Information:
This work was supported by the Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology.

Funding Information:
The Article Processing Charge was funded by the authors.

Funding Information:
This study was made possible using the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the NIH under Award Number R01AG034676. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Publisher Copyright:
© 2018 The Author(s).

ASJC Scopus Subject Areas

Neurology
Clinical Neurology

PubMed: MeSH publication types

Journal Article

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10.1212/NXI.0000000000000495

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Parks, N. E., Pittock, S. J., Mandrekar, J., Kantarci, O. H., Lucchinetti, C. F., Weinshenker, B. G., Mark Keegan, B., Oliver Tobin, W., Tillema, J. M., Toledano, M., & Flanagan, E. P. (2018). Population-based study of "no evident disease activity" in MS. Neurology: Neuroimmunology and NeuroInflammation, 5(6), Artículo e495. https://doi.org/10.1212/NXI.0000000000000495

@article{e18c1b861b2c47fba50eee2763db8456,

title = "Population-based study of {"}no evident disease activity{"} in MS",

abstract = "Objective To determine the persistence of no evident disease activity (NEDA) in a population-based relapsing-remitting MS (RRMS) cohort. Methods All incident cases of RRMS in Olmsted County between 2000 and 2011 were identified using a medical records linkage system. Persistence of NEDA after RRMS diagnosis was determined by retrospective chart review. MRI activity, relapse, or Expanded Disability Status Scale (EDSS) worsening resulted in failure of NEDA. Results We identified 93 incident cases of RRMS including 82 individuals with sufficient follow-up to determine the persistence of NEDA. There were 44 individuals not on disease-modifying therapy (DMT), whereas 37 individuals were prescribed an injectable DMT and 1 received mitoxantrone during the interval over which NEDA was maintained. NEDA was maintained by 63% at 1 year, 38% at 2 years, 19% at 5 years, and 12% at 10 years according to routine care assessment. At 10 years, there was no difference in EDSS disability among patients who maintained NEDA vs those who failed NEDA at 1 year (p = 0.3). Conclusions NEDA infrequently persists beyond 2 years in a population-based cohort of newly diagnosed patients with RRMS.",

author = "Parks, {Natalie E.} and Pittock, {Sean J.} and Jay Mandrekar and Kantarci, {Orhun H.} and Lucchinetti, {Claudia F.} and Weinshenker, {Brian G.} and {Mark Keegan}, B. and {Oliver Tobin}, W. and Tillema, {Jan Mendelt} and Michel Toledano and Flanagan, {Eoin P.}",

note = "Funding Information: This work was supported by the Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology. Funding Information: The Article Processing Charge was funded by the authors. Funding Information: This study was made possible using the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the NIH under Award Number R01AG034676. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Publisher Copyright: {\textcopyright} 2018 The Author(s).",

year = "2018",

month = nov,

day = "1",

doi = "10.1212/NXI.0000000000000495",

language = "English",

volume = "5",

journal = "Neurology: Neuroimmunology and NeuroInflammation",

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T1 - Population-based study of "no evident disease activity" in MS

AU - Parks, Natalie E.

AU - Pittock, Sean J.

AU - Mandrekar, Jay

AU - Kantarci, Orhun H.

AU - Lucchinetti, Claudia F.

AU - Weinshenker, Brian G.

AU - Mark Keegan, B.

AU - Oliver Tobin, W.

AU - Tillema, Jan Mendelt

AU - Toledano, Michel

AU - Flanagan, Eoin P.

N1 - Funding Information: This work was supported by the Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology. Funding Information: The Article Processing Charge was funded by the authors. Funding Information: This study was made possible using the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the NIH under Award Number R01AG034676. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Publisher Copyright: © 2018 The Author(s).

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Objective To determine the persistence of no evident disease activity (NEDA) in a population-based relapsing-remitting MS (RRMS) cohort. Methods All incident cases of RRMS in Olmsted County between 2000 and 2011 were identified using a medical records linkage system. Persistence of NEDA after RRMS diagnosis was determined by retrospective chart review. MRI activity, relapse, or Expanded Disability Status Scale (EDSS) worsening resulted in failure of NEDA. Results We identified 93 incident cases of RRMS including 82 individuals with sufficient follow-up to determine the persistence of NEDA. There were 44 individuals not on disease-modifying therapy (DMT), whereas 37 individuals were prescribed an injectable DMT and 1 received mitoxantrone during the interval over which NEDA was maintained. NEDA was maintained by 63% at 1 year, 38% at 2 years, 19% at 5 years, and 12% at 10 years according to routine care assessment. At 10 years, there was no difference in EDSS disability among patients who maintained NEDA vs those who failed NEDA at 1 year (p = 0.3). Conclusions NEDA infrequently persists beyond 2 years in a population-based cohort of newly diagnosed patients with RRMS.

AB - Objective To determine the persistence of no evident disease activity (NEDA) in a population-based relapsing-remitting MS (RRMS) cohort. Methods All incident cases of RRMS in Olmsted County between 2000 and 2011 were identified using a medical records linkage system. Persistence of NEDA after RRMS diagnosis was determined by retrospective chart review. MRI activity, relapse, or Expanded Disability Status Scale (EDSS) worsening resulted in failure of NEDA. Results We identified 93 incident cases of RRMS including 82 individuals with sufficient follow-up to determine the persistence of NEDA. There were 44 individuals not on disease-modifying therapy (DMT), whereas 37 individuals were prescribed an injectable DMT and 1 received mitoxantrone during the interval over which NEDA was maintained. NEDA was maintained by 63% at 1 year, 38% at 2 years, 19% at 5 years, and 12% at 10 years according to routine care assessment. At 10 years, there was no difference in EDSS disability among patients who maintained NEDA vs those who failed NEDA at 1 year (p = 0.3). Conclusions NEDA infrequently persists beyond 2 years in a population-based cohort of newly diagnosed patients with RRMS.

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Population-based study of "no evident disease activity" in MS

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