No evidence of disease activity in multiple sclerosis patients

Matta, André Palma da Cunha; Nascimento, Osvaldo J. M.; Ferreira, Ana Carolina Andorinho de F.; Magalhães, Thaís Nascimento; Benevides, T.P.R.; Kirmse, Arielle; Dib, Joao; Cal, Henrique; Orsini, Marco; Araujo, Lucas Masiêro

doi:10.1080/14737175.2016.1202763

Cited by 10 publications

(6 citation statements)

References 25 publications

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“…Several studies have shown that natalizumab is effective in reducing markers of physical disability (EDSS), cognitive decline (SDMT), and various MRI markers of disease activity (Gadolinium (Gd)-enhancing lesions, T2 lesions, brain atrophy) [11–13]. There is little if any information regarding the effects of natalizumab on the OCT surrogate marker of disease activity in MS. More recently, the effectiveness of MS treatments have been gauged by using another composite metric known as no evidence of disease activity (NEDA), which usually includes no progression on EDSS scores, lack of any new MRI activity (new contrast enhancing lesions and new or enlarging T2 lesions), and lack of any relapses [14,15]. This 3-component metric is referred to as NEDA-3.…”

Section: Introductionmentioning

confidence: 99%

Natalizumab stabilizes physical, cognitive, MRI, and OCT markers of disease activity: A prospective, non-randomized pilot study

et al. 2017

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Natalizumab is an effective therapy for multiple sclerosis (MS). Its effectiveness has been demonstrated in several clinical and imaging studies. The objective of this study was to further demonstrate the efficacy of natalizumab using a comprehensive battery of clinical and imaging markers in the same cohort of patients followed longitudinally, hence capturing the multi-faceted nature of the MS disease process. A prospective, open-label, pilot study of 20 MS patients treated with natalizumab was conducted. High resolution MRI, Symbol-Digit Modalities Test (SDMT), and Optical Coherence Tomography (OCT) scans were obtained at baseline, 48, and 96 weeks. 15 patients completed the study. Natalizumab treatment decreased Expanded Disability Status Scale score (EDSS) and no change in SDMT, Brain Parenchymal Fraction (BPF), or any of the OCT markers of retinal degeneration was observed. Thalamic and whole brain volume as assessed by Percentage Brain Volume Change (PBVC) showed continuous deterioration. Higher baseline T2 lesion load correlated with increased rate of PBVC at 96-weeks (r = 0.566, R2 = 0.320, p = 0.035) and thalamic volume loss (r = -0.586, R2 = 0.344, p = 0.027). Most patients, 93%, achieved no evidence of disease activity (NEDA) at 2 years, likely due to early disease duration and lower initial baseline lesion load. This study further demonstrates stabilization of clinical and imaging markers of disease activity during natalizumab treatment.

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Section: Introductionmentioning

confidence: 99%

Natalizumab stabilizes physical, cognitive, MRI, and OCT markers of disease activity: A prospective, non-randomized pilot study

et al. 2017

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“…"No evidence of disease activity (NEDA)" status has emerged as a composite measure of RRMS treatment success and is defined as "no evidence of relapse," "no evidence of disability progression," and "no MRI activity, namely absence of new or enlarging T2 lesions or Gd-enhancing lesions" (Matta et al 2016). NEDA is used as a primary endpoint in AHSCT.…”

Section: Follow-up and Outcomementioning

confidence: 99%

Stem Cell Therapy for Multiple Sclerosis

Genc

Bozan

Genç

et al. 2018

Advances in Experimental Medicine and Biology

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Multiple sclerosis (MS) is a chronic inflammatory, autoimmune, and neurodegenerative disease of the central nervous system (CNS). It is characterized by demyelination and neuronal loss that is induced by attack of autoreactive T cells to the myelin sheath and endogenous remyelination failure, eventually leading to functional neurological disability. Although recent evidence suggests that MS relapses are induced by environmental and exogenous triggers such as viral infections in a genetic background, its very complex pathogenesis is not completely understood. Therefore, the efficiency of current immunosuppression-based therapies of MS is too low, and emerging disease-modifying immunomodulatory agents such as fingolimod and dimethyl fumarate cannot stop progressive neurodegenerative process. Thus, the cell replacement therapy approach that aims to overcome neuronal cell loss and remyelination failure and to increase endogenous myelin repair capacity is considered as an alternative treatment option. A wide variety of preclinical studies, using experimental autoimmune encephalomyelitis model of MS, have recently shown that grafted cells with different origins including mesenchymal stem cells (MSCs), neural precursor and stem cells, and induced-pluripotent stem cells have the ability to repair CNS lesions and to recover functional neurological deficits. The results of ongoing autologous hematopoietic stem cell therapy studies, with the advantage of peripheral administration to the patients, have suggested that cell replacement therapy is also a feasible option for immunomodulatory treatment of MS. In this chapter, we overview cell sources and applications of the stem cell therapy for treatment of MS. We also discuss challenges including those associated with administration route, immune responses to grafted cells, integration of these cells to existing neural circuits, and risk of tumor growth. Finally, future prospects of stem cell therapy for MS are addressed.

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“…No evidence of disease activity (NEDA), defined as the absence of clinical relapses, disability progression, and MRI evidence of active disease, has been proposed as a treatment objective for adult-onset MS. 49 While it may be a good ideal to strive for attaining this target, maintaining a reasonable risk-benefit ratio may also be difficult in some patients. Treatment optimization is therefore often a compromise between long-term safety and what constitutes tolerable levels of disease activity.…”

Section: Therapy Goalsmentioning

confidence: 99%

Acute and Chronic Therapies in Pediatric Inflammatory Central Nervous System Diseases

Wilbur

Yeh

2017

J Pediatr Neurol

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Recognition of pediatric neuroinflammatory disorders has increased in recent years, together with an increased knowledge of the immune mechanisms underlying these disorders. These insights have led to paying greater attention to the classification of these disorders, and importantly, increasing information on therapeutic interventions that may improve outcomes. Furthermore, this has occurred in the wake of the development of multiple targeted immune therapies, thus creating a complex treatment landscape. This review aims to summarize the available literature regarding acute and chronic therapies for pediatric inflammatory central nervous system (CNS) disorders. A standardized approach to the initial management of these diseases is presented.

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No evidence of disease activity in multiple sclerosis patients

Cited by 10 publications

References 25 publications

Natalizumab stabilizes physical, cognitive, MRI, and OCT markers of disease activity: A prospective, non-randomized pilot study

Natalizumab stabilizes physical, cognitive, MRI, and OCT markers of disease activity: A prospective, non-randomized pilot study

Stem Cell Therapy for Multiple Sclerosis

Acute and Chronic Therapies in Pediatric Inflammatory Central Nervous System Diseases

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