AI-driven Evaluation of PIRA and Treatment Efficacy in Multiple Sclerosis: Insights from the BeCare MS App
Sharon Stoll1, larry rubin2, Charisse Litchman2
1Stoll Medical Group, 2BeCare Link
Objective:
This study evaluates the efficacy of the BeCare MS mobile app in detecting neurologic changes in patients treated with low efficacy versus high efficacy therapeutics.
Background:
Multiple sclerosis (MS) is a leading cause of disability among working-age individuals. Despite over 25 approved disease-modifying therapies (DMTs), disease progression remains a significant concern. Recently, Progression Independent of Relapse Activity (PIRA) has emerged as a critical treatment goal, underscoring the need for more efficient and quantitative measures of disability.
Design/Methods:
We conducted a retrospective review of data from over 7,000 BeCare MS app users. The app uses phone sensors and questionnaires to quantitatively measure neurologic dysfunction and disability scores (EDSS). Gamified activities reflect assessments typically performed in MS clinics, measuring cognitive skills across four domains: memory, processing speed, executive function, and language. Users completed various tests, including fine motor and the 25-foot walk, contributing to the calculation of population percentiles based on performance.
Results:
We compared improvements in performance between low efficacy treatments (interferons, Glatiramer Acetate, and Teriflunomide) and high efficacy treatments (anti-CD20 MABs and S1P modulators) over a minimum of 90 days. Of 162 users in the low efficacy group and 224 in the high efficacy group, many were excluded due to insufficient data. Improvement, defined as increased population scores over time, was observed in both groups. Specifically, 36% of low efficacy users improved in the fine motor testing compared to 44% in the high efficacy group. Additionally, 33% of low efficacy users showed improvement in the 25-foot walk, compared to 37% in the high efficacy group.
Conclusions:
Patients using high efficacy therapies demonstrated greater improvement than those on low efficacy treatments. While the study is limited by app usage frequency and sample size, it highlights the BeCare MS App's potential as a digital tool for assessing performance and quantifying disability in MS patients, including PIRA.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.