The tale of Two Civies. Aim for NEDA

McCarthy CL, Giovannoni G, Coles AJ. Timing is everything in the treatment of multiple sclerosis. BMJ Case Rep. 2015 Apr;2015. pii: bcr2014208960.

We present two similar cases of relapsing-remitting multiple sclerosis, both of whom received treatment with the monoclonal antibody alemtuzumab, but had significantly different long-term outcomes. 



Alemtuzumab is an effective DMT, but there appears to be a constant flow of comments circulating about its therapeutic value. This view in my opinion is misguided. The question is not whether it works as it does,the question is the risk:benefit issues

This report of two civilians (civies) by ProfG & C highlight some stark consequences.  With active MS you may have the choice of Lemtrada, unless you have a risk-averse Neuro and worryingly an NHS trust that is rationing your access to drugs.

This study highlights the importance of aiming for and achieving NEDA, it may occur with a low efficacy DMT, but the chances are it may not. Some people on the blog have argued that relapses are not important in the prognosis of MS. This study highlights that this is not the case. Aim for NEDA it is risky not to.

CoI: Prof G was an author of the paper. Multiple 

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