A longitudinal evaluation of the relationship between no evidence of disease activity and progression of cerebral atrophy and cognitive dysfunction in patients with multiple sclerosis

• Grant number: 16/04270-0
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• Start date: October 01, 2016
• End date: September 30, 2018
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Fernando Cendes
• Grantee: Alfredo Damasceno
• Host Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

Multiple Sclerosis (MS) is a demyelinating and inflammatory disease of the central nervous system which causes a high socioeconomic cost for health care systems and society as a whole. Over the last decade, the scenario of available disease-modifying therapies (DMT) for MS has rapidly changed and has incorporated drugs that surpass in efficacy the first approved DMTs. Nevertheless, therapeutic progress has led to evolving treatment goals. Assessment of efficacy has relied so far mainly on reduction of annualized relapse rate and disability progression, but these endpoints are becoming impractical nowadays. Therefore, the concept of no evidence of disease activity (NEDA) has recently emerged as a newly employed outcome metric that has the potential to advance clinical trial design. However, its prognostic utility in assessing MS disability still needs to be established. Additionally, this composite measure does not include assessment of cognitive function and brain atrophy, and currently some experts in the field suggest the addition of these measures to the composite outcome. Nevertheless, it is not known if adding cognitive and brain atrophy evaluation is indeed feasible, and whether maintaining NEDA status would have a positive impact on these measures. Therefore, a simple and accurate outcome measure is lacking, yet extremely needed in MS. In this setting, we aimed to evaluate NEDA status after six years of follow-up in a cohort of MS patients, exploring its implications on cognitive and brain atrophy measures.

Scientific publications

(6)

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

DAMASCENO, ALFREDO; SANTIAGO DOS SANTOS AMARAL, JULIANA MACHADO; BARREIRA, AMILTON ANTUNES; BECKER, JEFFERSON; CALLEGARO, DAGOBERTO; CAMPANHOLO, KENIA REPISO; DAMASCENO, LUCIANA AZEVEDO; DINIZ, DENISE SISTEROLLI; FRAGOSO, YARA DADALTI; FRANCO, PAULA S.; et al. Normative values of the Brief Repeatable Battery of Neuropsychological Tests in a Brazilian population sample: discrete and regression-based norms. Arquivos de Neuro-Psiquiatria, v. 76, n. 3, p. 163-169, MAR 2018. (16/04270-0)

DAMASCENO, ALFREDO; DIAS-CARNEIRO, RAFAEL PATERNO C.; MORAES, ADRIEL SANTOS; BOLDRINI, VINICIUS O.; QUINTILIANO, RAPHAEL PATRICIO S.; DE PAULA GALDINO DA SILVA, VERONICA ALMEIDA; FARIAS, ALESSANDRO S.; BRANDAO, CARLOS OTAVIO; DAMASCENO, BENITO PEREIRA; BARBOSA DOS SANTOS, LEONILDA MARIA; et al. Clinical and MRI correlates of CSF neurofilament light chain levels in relapsing and progressive MS. MULTIPLE SCLEROSIS AND RELATED DISORDERS, v. 30, p. 149-153, MAY 2019. (13/07559-3, 16/04270-0)

DAMASCENO, ALFREDO; PIMENTEL-SILVA, LUCIANA RAMALHO; DAMASCENO, BENITO PEREIRA; CENDES, FERNANDO. Are we ready to define cognitive worsening in MS? How different cutoffs detect future cognitive worsening after six years of follow-up. MULTIPLE SCLEROSIS AND RELATED DISORDERS, v. 69, p. 7-pg., 2022-11-12. (16/04270-0)

DAMASCENO, A.; PIMENTEL-SILVA, L.; DAMASCENO, B.; CENDES, F.. Cognitive trajectories in relapsing-remitting multiple sclerosis: a longitudinal six-year study. MULTIPLE SCLEROSIS, v. 25, p. 1-pg., 2019-09-01. (16/04270-0)

DAMASCENO, ALFREDO; PIMENTEL-SILVA, LUCIANA RAMALHO; DAMASCENO, BENITO PEREIRA; CENDES, FERNANDO. Cognitive trajectories in relapsing-remitting multiple sclerosis: A longitudinal 6-year study. MULTIPLE SCLEROSIS, v. 26, n. 13, OCT 2019. (16/04270-0)

DAMASCENO, ALFREDO; PIMENTEL-SILVA, LUCIANA RAMALHO; DAMASCENO, BENITO PEREIRA; CENDES, FERNANDO. Exploring the performance of outcome measures in MS for predicting cognitive and clinical progression in the following years. MULTIPLE SCLEROSIS AND RELATED DISORDERS, v. 46, NOV 2020. (16/04270-0)