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Living with Multiple Sclerosis (MS) brings with it, among plenty of other unwanted things, an array of acronyms that no one outside of the MS community will understand. After all, even the name MS is regularly abbreviated.

And now there’s a new acronym on the block that you need to know about: NEDA.

No evidence of disease activity (NEDA) is a new goal that is emerging for MS treatment. The aim of NEDA is, through treatment, to reach a point where people with the relapsing remitting form of MS (RRMS) are experiencing:1,2

  • No relapses
  • No increase in disability, as measured by the expanded disability status scale (EDSS)
  • No new or active lesions on brain/MRI scans. 

In combination, these three parameters for measuring MS are referred to as the NEDA-3.

Treatment has traditionally been focused on reducing the number of relapses in MS, but more recent thinking suggests that a relapse is not a sufficient indicator of MS activity. The inflammation caused by MS does not always cause a relapse, or other visible symptoms, but can still cause changes visible on a brain scan. NEDA aims to keep people free of both the visible signs of the disease and the silent disease activity.

The idea with NEDA is to start treatment with disease modifying drugs (DMDs) early to prevent a build-up of symptoms and nerve damage. Regular reviews of MS activity with the three NEDA parameters outlined above should then guide treatment options. If no evidence of disease activity is seen, then your current regime is probably working, while if activity is detected, you may wish to consider switching treatments. 

NEDA is still in its early days, but long-term follow-ups suggest that monitoring MS with these parameters, and acting once activity is detected, is related to better health and disability status 16 and 21 years later.1

For people with progressive MS, NEPAD (no evidence of progression or active disease) is considered to be a more appropriate goal for treatment. In progressive forms of the disease, increasing disability is the primary concern and so the emphasis is placed on slowing or preventing progression rather than no disease activity. In addition, to EDSS as a measure of disability, NEPAD also looks at walking tests and the 9-hole peg test (a test that measures arm and hand function).1

Just in case you weren’t counting, we make that eight acronyms in this article. But for managing your MS, NEDA is one acronym you may want to consider discussing with your doctor. Try using the YourMS Questionnaire to keep an eye on your symptoms and have an informed discussion with your doctor about NEDA.  

1 MS Trust. NEDA (no evidence of disease activity). Available at: https://mstrust.org.uk/a-z/neda-no-evidence-disease-activity. Accessed May 2021.

2 Pandit L. No Evidence of Disease Activity (NEDA) in Multiple Sclerosis - Shifting the Goal Posts. Ann Indian Acad Neurol. 2019; 22(3):261-263.

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