Using the DAAE Score to Advance Personalized Medicine for Multiple Sclerosis: Tom Fuchs, MD, PhD

WATCH TIME: 5 minutes

"The DAAE score 2.0 allows clinicians to sit with patients and say, 'Here is your risk, and here’s how it changes with different therapies,' enabling personalized, informed decisions."

To address the issues of predicting progression in multiple sclerosis (MS) is difficult to predict, researchers recently developed the DAAE score, a clinical tool for estimating risk of conversion to secondary progressive MS (SPMS). In a recent large international study, findings revealed that the DAAE score had a high performance in both primary and secondary validation. In addition, risk estimations for conversion to SPMS displayed consistently lower among patients receiving high-efficacy disease modifying therapy (DMT). Thus, these results suggest that the tool can be used to improve personalized medicine for patients with MS.¹

Investigators assessed the DAAE score over 5 years using data from the international MSBase consortium database (patients, n = 29,373; women, 72.5%; mean age, 39.6 [SD, 10]; disease duration, 7.9 [SD, 5.2]). In primary validation, risk of conversion increased proportionally across risk groups, which was consistent with previous estimates (P >.05). Secondary validation resulted in an area-under-receiver-operating-curve of 0.773 (95% CI, 0.766-0.779). In 1: 1 propensity-score matched data, high-efficacy DMT (n = 2,831) was associated with lower risk of conversion to SPMS (P <.001) relative to patients receiving low-efficacy DMT (n = 2831). Notably, risk of conversion across risk groups in those who received high-efficacy DMT was consistently lower relative to patients receiving low-efficacy therapy.

Lead author Tom Fuchs, MD, PhD, presented these findings at the 2024 European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress, held September 18-20, in Copenhagen, Denmark. During the event, Fuchs, a postdoctoral researcher at Amsterdam University Medical Center, sat down to discuss the improvements in the DAAE score 2.0 in predicting MS progression since its inception. He also talked about the key factors considered by the DAAE score when assessing a patient's risk of progression to secondary progressive MS. Moreover, he spoke about how the DAAE score facilitates conversations between patients and clinicians about the risks as well as the benefits of different treatment approaches.

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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.