Author Topic: Serum neurofilament light chains as MS biomarker  (Read 44 times)

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Online agate

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Serum neurofilament light chains as MS biomarker
« on: June 04, 2019, 04:25:51 pm »
The abstracts from the recent AAN conference included quite a large number on the topic of serum neurofilament light chains as a biomarker for MS. This brief article and comment from NEJM Journal Watch (June 4, 2019) tells a little about them:

Serum Neurofilament Light Chain as a Prognostic Marker in Multiple Sclerosis

Robert T. Naismith, MD reviewing Kuhle J et al. Neurology 2019 Mar 5

Patients with high NfL levels had increased risk for worse disease outcomes.

Neurofilament light chain (NfL) in serum and cerebrospinal fluid is an indicator of axonal injury associated with multiple sclerosis (MS). To evaluate this molecule as a prognostic biomarker, investigators measured serum NfL in patients with relapsing-remitting MS enrolled in two phase III studies of fingolimod. In the FREEDOMS study, 269 participants received fingolimod or placebo for 24 months; in the TRANSFORMS study, 320 participants received fingolimod or interferon β-1a for 12 months.

Compared with 35 healthy controls (HC), patients with MS had higher baseline serum NfL (30.5 pg/mL [FREEDOMS], 27.0 pg/mL [TRANSFORMS], 16.9 pg/mL [HC]). High baseline NfL levels were positively associated with high volume of T2-weighted lesions as well as presence of gadolinium-enhancing (Gd+) lesions. Among patients with Gd+ lesions, NfL levels were 64% higher (FREEDOMS) and 48% higher (TRANSFORMS) than among patients without Gd+ lesions. At 6 months, NfL concentrations fell from baseline by 35% (FREEDOMS) and 36% (TRANSFORMS). Compared with patients who had baseline NfL levels <30 pg/mL, those with NfL concentrations >60 pg/mL were 2.6 times more likely to have a new or enlarging T2 lesion and 2.5 times more likely to have a relapse; they also had 2.9 times greater loss of brain volume and 1.9 times higher risk for worsening disability.


As a reflection of axonal damage, NfL is a promising biomarker for monitoring disease activity and progression in MS. This analysis confirms that NfL levels are elevated in patients with MS and diminish with treatment; moreover, baseline NfL levels predict risk for relapse, disability, new lesions, and brain atrophy. NfL is now an important tool in many MS trials and it may someday become a core prognostic gauge to complement the existing clinical and imaging measures.
« Last Edit: November 05, 2019, 09:38:41 pm by agate »
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SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010.


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