Clinical implications of serum neurofilament in newly diagnosed MS patients: A longitudinal multicentre cohort study

Abstract

Background: We aim to evaluate serum neurofilament light chain (sNfL), indicating neuroaxonal damage, as a biomarker at diagnosis in a large cohort of early multiple sclerosis (MS) patients. Methods: In a multicentre prospective longitudinal observational cohort, patients with newly diagnosed relapsing-remitting MS (RRMS) or clinically isolated syndrome (CIS) were recruited between August 2010 and November 2015 in 22 centers. Clinical parameters, MRI, and sNfL levels (measured by single molecule array) were assessed at baseline and up to four-year follow-up. Findings: Of 814 patients, 54.7% (445) were diagnosed with RRMS and 45.3% (369) with CIS when applying 2010 McDonald criteria (RRMS[2010] and CIS[2010]). After reclassification of CIS [2010] patients with existing CSF analysis, according to 2017 criteria, sNfL levels were lower in CIS[2017] than RRMS[2017] patients (9.1 pg/ml, IQR 6.2À13.7 pg/ml, n = 45; 10.8 pg/ml, IQR 7.4À20.1 pg/ml, n = 213; p = 0.036

Longitudinal Serum Neurofilament Levels of Multiple Sclerosis Patients Before and After Treatment with First-Line Immunomodulatory Therapies

“…As this was a retrospective analysis of serum NfL in a prospectively collected cohort, pre-analytical effects on serum NfL outcomes must be considered as samples were stored for more than 10 years. However, the observed values were in the same range as those of comparable patients [30,34,35] and of particular interest as no other therapies were available at this time and thereby we were able to monitor long-term outcomes of serum NfL in this specific study population. We can also not completely rule out spontaneous processes or regression that influences serum NfL (sNfL) levels, as we did not include untreated, stable MS patients.…”

Identification of two highly antigenic epitope markers predicting multiple sclerosis in optic neuritis patients

“…To date, there are no biomarkers that predict ON progression to MS . Most recent findings indicated that serum neurofilament light chain (sNfL) might serve as a biomarker from very early stages of MS (see also ref in [23] ). It will be important to investigate the additional diagnostic value of epitopes A and B would carry for patients with first MS symptoms and high initial sNfL levels all combined as serologic biomarkers for the disease course prognosis.…”

Serum neurofilament light in MS: The first true blood-based biomarker?

“…44 In a prospective longitudinal cohort of early MS (early relapsing or clinically isolated syndrome), patients who remained treatment naïve had lower sNfL than those who needed disease-modifying treatment within 4 years: subsequent to treatment initiation the sNfL levels reduced. 35 Several other studies have shown that in patients with confirmed relapsing or progressive MS, baseline sNfL predicts short-term outcomes (up to 5 years) including relapses, MRI disease activity, disability worsening, MRI brain and spinal cord atrophy, and poorer cognitive outcomes. 24,45 The Swiss group have presented preliminary but important evidence from 1366 MS patients followed for a median of 5 years.…”