The Philosophy and Future of the DAAE Score in Multiple Sclerosis Care: Tom Fuchs, MD, PhD

WATCH TIME: 7 minutes

“Tools we develop for personalized medicine must be clinically accessible.”

Since predicting the progression of multiple sclerosis (MS) to secondary progressive MS (SPMS) has been challenging, researchers created the DAAE score, a clinical tool designed to estimate this risk and assist clinicians. A recent large-scale international study demonstrated that the DAAE score performed well in both primary and secondary validation. Additionally, patients treated with high-efficacy disease-modifying therapies (DMTs) consistently showed lower risk estimates for conversion to SPMS, suggesting the tool’s potential to enhance personalized care for patients with MS.

Over a 5-year period, investigators evaluated the DAAE score using data from the MSBase consortium, which included 29373 patients. Primary validation confirmed that risk of conversion increased proportionally across risk groups, aligning with previous estimates (P > .05). Secondary validation showed a strong predictive accuracy, with an area-under-the-curve of 0.773 (95% CI, 0.766–0.779). In a 1:1 propensity-matched analysis, patients on high-efficacy DMTs (n = 2,831) had significantly lower risk of conversion to SPMS (P < .001) compared with those on low-efficacy DMTs (n = 2,831). Moreover, the risk of conversion in all risk groups remained consistently lower for patients receiving high-efficacy therapy than for those on low-efficacy treatment.

These results were presented by lead author Tom Fuchs, MD, PhD, at the 2024 European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress, held September 18-20, in Copenhagen, Denmark. Fuchs, a postdoctoral researcher at Amsterdam University Medical Center, discussed the implications of this research in an interview with NeurologyLive^®, emphasizing the importance of advancing predictive tools like the DAAE score to support personalized MS care. During the conversation, he highlighted key questions driving future innovations, including how tools like the DAAE Score might incorporate cognitive decline as a critical component of disease monitoring, how to ensure predictive tools remain feasible in resource-limited settings, and how emerging therapies might shape the focus of personalized medicine in MS.

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REFERENCES
1. Fuchs T, Schoonheim M, Uher T, et al. Practical Clinical Predictions: MSBase Validation of the DAAE Score, A Clinical Tool for Estimating Risk of Conversion to Secondary Progressive Multiple Sclerosis. Presented at: 2024 ECTRIMS; September 18-20; Copenhagen, Denmark. Abstract P063.