“No Evidence of Disease Activity”: Is it An Aspirational Therapeutic Goal in MS?

Abstract

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.