- “NfL predicts relapse-free progression in a longitudinal multiple sclerosis cohort study”: Timo Uphaus et al
-age at diagnosis, sNflL greater than or equal to 7.3 pg/ml are independent predictors of the relapse-free progression outcome
-overall predictive accuracy of sNfL at baseline for prediction of relapse-free progression 12 months prior to FU of 82%
-patients experiencing transition to SPMS had higher sNfL values at FU compared to patients without transition (conversion: 10.4 pg/ml vs non-conversion: 6.9 pg/ml) whereas baseline sNfL levels did not differ between later SPMS converters and non-converters
-individual longitudinal sNfL increases (FU higher than baseline) were more frequent in patients transition to SPMS (70.4%) than non-converters (47.3%)
-patients with both progression only and inflammation and progression at FU showed increased sNfL levels at baseline compared to patients with stable disease (progression only: 13.8 pg/ml; inflammation and progression: 12.3 pg/ml; stable: 5.3 pg/ml
-patients with inflammation and progression at FU exhibited the highest sNfL values at FU (sNfL inflammation and progression: 7.9 pg/ml vs patients without signs of inflammation or progression: 4.8 pg/ml
-patients experiencing inflammation only at FU showed higher sNfL values at FU compared to stable patients (sNfL inflammation only: 7.1 pg/ml)
-we aimed to unravel the ability of sNfL assessment to dissect inflammatory activity from disease progression
-patients with sNfL levels below 7.3 pg/ml have a rather low probability of experiencing disability progression; this might help to stratify immunomodulatory treatment strategies on an individual level and thereby enable patients to balance the potential long-term risk of side effects vs necessary treatment strength
-sNfL remained in the model after multivariable correction for age at sampling
-our observations expand previous findings, demonstrating an increased risk of EDSS worsening within the 12 months after sampling in patients with sNfL above the 80th percentile of healthy controls and increased to 15% in patients with sNfL values above the 97.5% percentile
-we observed the highest sNfL values in patients with disability relevant inflammatory activity (inflammation and progression), suggesting a role of sNfL for monitoring both disease progression and inflammatory activity
-sNfL at baseline was increased in patients with progression in presence and absence of inflammatory activity at FU
-while elevated sNfL levels reflect currency ongoing inflammatory-driven (focal) damage, they more importantly identify those early inflammatory processes resulting in later axonal loss associated with EDSS progression in the long run
-sNfL measures are capable of predicting disability progression at 12 months prior to 6 year follow up due to their ability to reflect disability relevant neuronal damage and are able to discriminate SPMS patients thereby facilitating an earlier diagnosis of patients at risk
- “Serum Neurofilament Light: A Biomarker of Neuronal Damage in Multiple Sclerosis” by Giulio Disanto et al
-sNfL percentiles for age 45: 80th: 29.1 pg/ml; 90th: 33.9 pg/ml; 95th: 38.9 pg/ml; 97.5th: 44.1 pg/ml; 99th: 51.9 pg/ml
-greater than 9 brain T2 lesions: 48 pg/ml
-2-9 brain T2 lesions: 30.2 pg/ml
-negative OCBs: 26.8 pg/ml
-male gender: 44.2 pg/ml
-this implies disease duration as a proxy for age
-sNfL concentrations were higher in PPMS/SPMS than CIS/RRMS
-positive associations were also found in univariate analyses between sNfL and EDSS
-increase in sNfL per EDSS unit increase was lower in PPMS/SPMS than in CIS/RRMs
-the decrease in SNfL with time since start of new treatment appeared similar across different DMTs
-the probability of having experienced worsening of EDSS within 6-12 months before
sampling was higher in patients with sNfL values above vs below the 90th, 95th, 97.5th
and 99th percentiles
-patients with sNfL above the 97.5th percentile had greater than 4-fold odds of having
experienced EDSS worsening in the previous 6-12 months
-the proportion of patients experiencing EDSS worsening within 12 months after sampling gradually increased with increasing sNfL percentile category
-sNfL is best explained by ongoing age-related neuronal degeneration
-ECL assay is less sensitive than SIMOA
-results in MS strongly suggest that sNfL levels reflect ongoing neuronal damage irrespective of the underlying pathogenic mechanism
-clear positive association between sNfL and focal inflammatory MRI lesions
-weak associations between sNfL and brain T2 and GE lesions in CIS patients
-sNfL measurements could be used to indicate recent neuronal damage and this could be particularly useful in cases of “clinically silent disease” or when clinical changes are difficult to interpret
-high sNfL levels were also associated with a higher risk of future clinical relapses and EDSS worsening
- “Chronic White Matter Inflammation and Serum Neurofilament Levels in Multiple Sclerosis”: Pietro Maggi, MD et al
-patients with greater than or equal to 2 PRLs compared to those with greater than or equal to 1 PRL had higher age-adjusted sNfL percentiles
-sNfL percentile levels were higher in PRLS greater than or equal to 2 cases
-MSSS (MS Severity Score scale) was not affected by DMT or T2 lesion load
-PRL in greater than or equal to 2 cases had on average 16 percentile point higher sNfL
-higher T2 lesion load and shorter disease duration were associated with 21% and 7% higher odds of having greater than or equal to 2 PRLs
-most patients with 2 or more PRLs had sNfL levels above the 80th percentile
Multiple Sclerosis Research Repository 