What is NEDA?

Since the first disease-modifying therapy (DMT) for multiple sclerosis (MS) was approved by the FDA in 1993, medications for MS have been developed to slow down the disease. Many have been shown in clinical studies to reduce the frequency of relapse and slow the accumulation of permanent disability.

As early as 2010, MS researchers began to suggest that rather than simply slowing down the disease, a clinical goal of therapy could be “freedom from disease activity.” The idea is that measuring the number of people with MS who can achieve freedom from disease activity could become a better gauge to determine therapeutic effectiveness. The concept is now referred to as “no evidence of disease activity,” or NEDA, for short.

What is NEDA?

While the definition of NEDA is evolving, “no evidence of disease activity” means exactly what is sounds like. A person with MS would show no signs of active disease — but this doesn’t mean that old symptoms or disability would disappear. For NEDA to occur, three conditions need to be met, the combination of which is sometimes called NEDA3.

• No clinical relapses or exacerbations
• No Gd-enhancing (active) lesions and/or no new or newly-enlarging T2 lesions
• No change in the neurological exam or confirmed disability progression

Note that these measures are focused primarily on inflammatory disease activity and do not readily capture other disease consequences, such as neurodegeneration. Researchers have suggested the addition of a fourth measure — brain volume loss— to provide a more comprehensive view of disease activity and progression. This new criteria is called NEDA4.

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'No Evidence of Disease Activity' in MS: What is NEDA, Anyway?