Neurofilament in clinical practice: Is the multiple sclerosis community ready?

Moccia, Marcello; Terracciano, Daniela; Brescia Morra, Vincenzo; Castaldo, Giuseppe

doi:10.1177/13524585241246536

Cited by 4 publications

(1 citation statement)

References 25 publications

(33 reference statements)

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“…Despite the prognostic and monitoring value of serial determinations of sNfL levels, consensus groups recently concluded that these analyses will not replace MRI over the short term but will be used as a complementary technique or with a greater frequency, given their lower cost, thereby optimizing neuroimaging [57,58].…”

Section: Discussionmentioning

confidence: 99%

Real‐World Study of Serum Neurofilament Light Chain Levels in Ocrelizumab‐Treated People with Relapsing Multiple Sclerosis

Barrero Hernández,

Romero Villarubia,

Muñoz Fernández

et al. 2024

Preprint

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Serum neurofilament light chain (sNfL) levels have been proposed as a biomarker of the clinical activity, disability progression, and response to treatment of people with multiple sclerosis (PwMS); however, questions remain about its implementation in clinical practice. Ocrelizumab (OCR) has proven effective to improve clinical and radiological outcomes and to reduce sNfL levels. This real-life study followed the sNfL levels of 30 PwMS treated for 12 months with OCR and evaluated the usefulness of this biomarker for the short-term prognosis, considering expanded disability status scale (EDSS), annualized relapse rate (ARR), radiological activity, and NEDA-3 values. OCR reduced the ARR in 83% of PwMS and the radiological activity in 80%. Their EDSS was maintained, while NEDA-3 was achieved in 70% at 12 months. OCR produced an early reduction in sNfL levels (at 3 months). At baseline, greater MRI-evaluated radiological activity was associated with higher sNfL levels. sNFL levels over the first 12 months of treatment did not predict a suboptimal response or sustained control of the disease. Longer-term studies are needed to explore the predictive usefulness of sNfL levels in PwMS treated with high-efficacy drugs

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Section: Discussionmentioning

confidence: 99%

Real‐World Study of Serum Neurofilament Light Chain Levels in Ocrelizumab‐Treated People with Relapsing Multiple Sclerosis

Barrero Hernández,

Romero Villarubia,

Muñoz Fernández

et al. 2024

Preprint

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The ocrelizumab wearing-off phenomenon is associated with reduced immunomodulatory response and increased neuroaxonal damage in multiple sclerosis

Monteiro,

Nicolella,

Fiorenza

et al. 2024

J Neurol

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Objective The wearing-off phenomenon is common in people with multiple sclerosis (MS) treated with ocrelizumab. We aim to evaluate the presence and severity of wearing-off to ocrelizumab in relation to demographic and MS clinical variables, immune profiling, and a marker of neuroaxonal damage (plasma neurofilament light chain (pNfl)). Methods This cross-sectional study included MS patients treated with ocrelizumab from at least 1 year. Wearing-off questionnaire and blood samples were collected between 21 and 23 weeks after the previous ocrelizumab infusion. Lymphocyte subpopulations were evaluated on peripheral blood using flow cytometry. PNfl was evaluated using fully automated chemiluminescent enzyme immunoassay. Results We included 106 people with MS (age 49.5 ± 11.6 years; females 42.3%; wearing-off 57.6%). On regression models, wearing-off was associated with higher pNfl, CD8, CD3, and CD3CD27 lymphocytes. Most frequent wearing-off symptoms were cognitive, sensory, and balance problems; wearing-off started < 1 week (9.4%), 1–4 weeks (10.7%) or > 4 weeks (10.7%) before infusion; 44.8% of the complaints were moderate to severe. Severity of wearing-off was associated with higher pNfl and CD8 lymphocytes. Conclusions Wearing-off is common in people with MS treated with ocrelizumab, and is associated with reduced immunomodulation (higher T lymphocytes) and increased neuroaxonal damage, suggesting reduced treatment response.

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Clinical utility of the Lumipulse™ immunoassay for plasma neurofilament light chain in multiple sclerosis

Nicolella,

Fiorenza,

Monteiro

et al. 2024

Journal of the Neurological Sciences

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Neurofilament in clinical practice: Is the multiple sclerosis community ready?

Cited by 4 publications

References 25 publications

Real‐World Study of Serum Neurofilament Light Chain Levels in Ocrelizumab‐Treated People with Relapsing Multiple Sclerosis

Real‐World Study of Serum Neurofilament Light Chain Levels in Ocrelizumab‐Treated People with Relapsing Multiple Sclerosis

The ocrelizumab wearing-off phenomenon is associated with reduced immunomodulatory response and increased neuroaxonal damage in multiple sclerosis

Clinical utility of the Lumipulse™ immunoassay for plasma neurofilament light chain in multiple sclerosis

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