No evidence of disease activity (NEDA) has surfaced as a key outcome measure in studies of relapsing remitting multiple sclerosis (RRMS), but its predictive value for long-term disability outcomes is unclear. Dalia Rotstein, MD, MPH, St. Michael’s Hospital and the University of Toronto, Toronto, ON, shares the findings of a systematic review and meta-analysis of real-world observational studies conducted to determine the use of NEDA in this context. Patients with a minimum of 4 years of follow-up were included in the study to evaluate the relationship between NEDA and Expanded Disability Status Scale (EDSS) worsening. The study calculated a pooled positive predictive value of NEDA for no EDSS worsening of 87.1%. The probability of EDSS worsening with evidence of disease activity (EDA) was 34.7%, meaning additional factors may be needed to guide further treatment decisions. Overall, NEDA was highly predictive of favorable long-term disability outcome. This interview took place during the ACTRIMS Forum 2021.