Freedom from disease activity in multiple sclerosis.
BACKGROUND
Multiple sclerosis (MS) shares many pathologic features with other immune-mediated inflammatory diseases, such as rheumatoid arthritis, Crohn disease, and psoriasis. The development of effective biologic agents for rheumatoid arthritis has resulted in a treatment paradigm shift such that disease remission is now an explicit goal.


CONCLUSIONS
The traditional immunomodulatory disease-modifying therapies for MS (interferon beta and glatiramer acetate) delay disease progression and reduce activity on brain MRI to varying degrees; however, they have not been demonstrated to induce disease remission. Therefore, the concept of disease remission or freedom from disease activity in MS has received little attention from the neurology community. We discuss some potential definitions of disease remission in MS and whether freedom from disease activity can become an increasingly useful measure of therapeutic response.


CONCLUSIONS
Future research should be directed at determining the long-term significance of freedom from disease activity during a short-term clinical trial in relapsing-remitting MS.
Havrdova
Eva
E
Department of Neurology, First Faculty of Medicine, Charles University in Prague, Katerinska 30, 12808 Praha 2, Czech Republic. eva.havrdova@gmail.com
Galetta
Steven
S
Stefoski
Dusan
D
Comi
Giancarlo
G
D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000503:physiopathology; D005104:Expert Testimony; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000503:physiopathology; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy; D000069442:Natalizumab; D012074:Remission Induction; D012720:Severity of Illness Index
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007155:Immunologic Factors; D000069442:Natalizumab