What elements beyond NEDA-3 do you find valuable for tracking disease progression in MS?

I do NOT use NEDA-3 for tracking disease progression. This is because it cannot predict the absence of long-term disability progression, and its weakest link is precisely the "progression" dimension, which is dominated by focal inflammatory MRI activity. It misses the smoldering neurodegeneration th...

NEDA-4 (NEDA-3 + early brain volume loss) is a valuable method to track disease progression though there have been meta-analyses (i.e., Rotstein et al., PMID 36224046) suggesting that adding this additional biomarker adds little to disease prediction. Recent data from the Harvard group suggests that...

I find NEDA-3 useful, but it is clearly incomplete, particularly for detecting gradual progression that occurs independently of relapses or new MRI lesions. In routine practice, fully quantifying progression and quality of life can be challenging, especially in a busy clinic. For me, what the patien...