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Updated: Mar 31, 2026
A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
Predictors of early NEDA-3 status after first disease-modifying therapy in a real-world Brazilian multiple sclerosis
Flávia Timbó Albuquerque1, Felipe Toscano Lins de Menezes1, Natasha Pryanka de Araújo Bessa1
1Neurology and Neurosurgery Division, Federal University of São Paulo (UNIFESP), Rua Botucatu, 740, São Paulo, SP 04023-900, Brazil.
Background:
No evidence of disease activity (NEDA-3) is widely recognized as a key therapeutic goal in multiple sclerosis (MS), reflecting complete suppression of both clinical and radiological activity. Despite its importance, there is limited real-world evidence on NEDA-3 attainment following the initiation of first-line disease-modifying therapy (DMT), particularly in middle-income countries. This study evaluated the proportion of people with MS (PwMS) who achieved NEDA-3 after the first year of treatment and identified clinical predictors associated with this outcome.
Methods:
We retrospectively analyzed 332 participants with relapsing-remitting MS who initiated their first DMT at a large tertiary neuroimmunology center in São Paulo, Brazil, between 1994 and 2019. NEDA-3 was defined as the simultaneous absence of relapses, confirmed disability progression, and MRI activity after one year. Logistic regression models identified independent predictors of NEDA-3 status.
Results:
After one year, 29.2% of participants met NEDA-3 criteria. Lower baseline disability (EDSS ≥3: OR = 0.51, 95% CI: 0.28-0.93; p = 0.027), fewer pre-treatment relapses (OR = 0.84, 95% CI: 0.72-0.98; p = 0.031), and use of moderate/high-efficacy DMTs (OR = 2.94, 95% CI: 1.47-5.88; p = 0.002) increased the likelihood of NEDA-3. In the multivariate model, both pre-treatment relapse counts and DMT efficacy remained independent predictors.
Conclusions:
In this real-world cohort, about one-third met NEDA-3 criteria after the first treatment year. Early disease control was more likely with moderate/high-efficacy therapy and a lower prior inflammatory burden. This result highlights the importance of timely and effective treatment in optimizing long-term MS outcomes.
