Minimal evidence of disease activity (MEDA) in relapsing-remitting multiple sclerosis.

This study aimed to define the minimal evidence of disease activity (MEDA) during treatment that can be tolerated without exposing patients with relapsing-remitting multiple sclerosis at risk of long-term disability. We retrospectively collected data of patients followed up to 10 years after starting interferon beta or glatiramer acetate. Survival analyses explored the association between the long-term risk of reaching an Expanded Disability Status Scale≥6.0 and early clinical and MRI activity assessed after the first and second year of treatment. Early disease activity was classified by the so-called 'MAGNIMS score' ( At follow-up, 148/1036 (14.3%) patients reached the outcome: 61/685 (8.9%) with Early marginal MRI activity of one to two new T2 lesions, in the absence of both relapses and CELs, is associated with a minor risk of future disability, thus representing a simple and valuable definition for MEDA.

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Déclaration de conflit d'intérêts

Competing interests: LP: consulting fees from Biogen, Novartis and Roche; speaker honoraria from Biogen, Genzyme, Merck Serono, Novartis and Teva; travel grants from Biogen, Genzyme, Novartis and Teva; research grants from the Italian MS Society (Associazione Italiana Sclerosi Multipla) and Genzyme. CM: no disclosures. SH: travel funding and/or speaker honoraria from Biogen, Roche, Genzyme, Novartis and CSL Behring. CC: fees as invited speaker and travel grants for attending meeting from Serono, Biogen, Teva and Novartis. LDG: travel grants from Biogen, Novartis and Teva. NDR: speaker honoraria from Biogen Idec, Genzyme, Novartis, Sanofi-Aventis; funding for participation in advisory board to Novartis and Genzyme-Sanofi and for travel to scientific meetings from Biogen Idec, Teva, Sanofi-Genzyme, Roche, Almirall and Novartis. SG: fees as invited speaker or travel expenses for attending meeting from Biogen, Merck-Serono, Teva, Almirall, Sanofi-Aventis, Novartis and Genzyme. S Rasia: fees as invited speaker or travel expenses for attending meeting from Biogen, Merck-Serono, Teva, Sanofi, Novartis and Genzyme. S Ruggieri: speaking honoraria from Merck Serono and Teva. CT: honoraria for speaking and travel grants from Biogen, Sanofi-Aventis, Merck Serono, Bayer-Schering, Teva, Genzyme, Almirall and Novartis. CP: scientific advisory boards for Actelion, Biogen, Genzyme, Hoffmann-La Roche, Merck-Serono, Novartis, Sanofi and Teva; consulting and/or speaking fees, research support and travel grants from Allergan, Almirall, Biogen, Genzyme, Hoffmann-La Roche, Merck-Serono, Novartis, Sanofi and Teva. CG: fees as invited speaker or travel expenses for attending meeting from Biogen, Merck-Serono, Teva, Sanofi, Novartis and Genzyme.