Serum Neurofilament Light Levels May Reflect the Efficacy of MS Treatments

PARIS—It is possible to gauge the effects of disease-modifying therapies (DMTs) for multiple sclerosis (MS) by measuring serum levels of neurofilament light (NFL), according to research presented at the Seventh Joint ECTRIMS–ACTRIMS Meeting. DMTs with greater efficacy appear to be associated with lower serum NFL concentrations.

NFL is a biomarker of axonal damage that has been measured primarily in CSF. In patients with MS, the CSF NFL concentration reflects disease activity and the efficacy of DMTs. Investigators recently developed an ultrasensitive immunoassay that can determine NFL levels in serum.

 To examine the effect of DMTs on serum NFL, Lenka Nováková, MD, a neurologist at Sahlgrenska University Hospital in Gothenburg, Sweden, and colleagues measured serum NFL concentrations in 98 patients with relapsing-remitting MS and 48 patients with progressive MS. Serum samples were obtained before and after treatment, with a median time interval of 12 months between measurements. During the interval, eight patients remained untreated, 10 initiated first-line treatment, 41 initiated second-line treatment, 67 escalated from first-line to second-line treatment, 17 switched from one second-line treatment to a different second-line treatment, two switched from a first-line treatment to a different first-line treatment, and one stopped treatment.

The investigators measured serum NFL concentrations using an in-house ultrasensitive single molecule array immunoassay. The intra-assay and inter-assay coefficient of variation was less than 10%.

Median serum NFL concentration decreased significantly in treatment-naïve patients who initiated second-line DMTs (ie, from 22.7 ng/L to 18.5 ng/L) or escalated from a first-line to a second-line DMT (ie, from 17.9 ng/L to 12.6 ng/L). The median serum NFL concentration was stable in patients who switched between second-line DMTs (14.9 ng/L before the switch and 13.7 ng/L after the switch). Similarly, the median serum NFL concentration did not change significantly in patients who stayed untreated (40.7 ng/L at first measurement and 37.1 ng/L at second measurement), initiated first-line treatment (20.6 ng/L vs 25.5 ng/L), or switched between first-line DMTs (17.3 ng/L vs 16.7 ng/L).

“The goal of DMTs in MS is to reduce axonal degeneration,” said Dr. Nováková. “Repeated analysis of serum NFL may represent a new possibility to monitor this process and may provide objective support in treatment decisions.”

 

PARIS—It is possible to gauge the effects of disease-modifying therapies (DMTs) for multiple sclerosis (MS) by measuring serum levels of neurofilament light (NFL), according to research presented at the Seventh Joint ECTRIMS–ACTRIMS Meeting. DMTs with greater efficacy appear to be associated with lower serum NFL concentrations.

NFL is a biomarker of axonal damage that has been measured primarily in CSF. In patients with MS, the CSF NFL concentration reflects disease activity and the efficacy of DMTs. Investigators recently developed an ultrasensitive immunoassay that can determine NFL levels in serum.

 To examine the effect of DMTs on serum NFL, Lenka Nováková, MD, a neurologist at Sahlgrenska University Hospital in Gothenburg, Sweden, and colleagues measured serum NFL concentrations in 98 patients with relapsing-remitting MS and 48 patients with progressive MS. Serum samples were obtained before and after treatment, with a median time interval of 12 months between measurements. During the interval, eight patients remained untreated, 10 initiated first-line treatment, 41 initiated second-line treatment, 67 escalated from first-line to second-line treatment, 17 switched from one second-line treatment to a different second-line treatment, two switched from a first-line treatment to a different first-line treatment, and one stopped treatment.

The investigators measured serum NFL concentrations using an in-house ultrasensitive single molecule array immunoassay. The intra-assay and inter-assay coefficient of variation was less than 10%.

Median serum NFL concentration decreased significantly in treatment-naïve patients who initiated second-line DMTs (ie, from 22.7 ng/L to 18.5 ng/L) or escalated from a first-line to a second-line DMT (ie, from 17.9 ng/L to 12.6 ng/L). The median serum NFL concentration was stable in patients who switched between second-line DMTs (14.9 ng/L before the switch and 13.7 ng/L after the switch). Similarly, the median serum NFL concentration did not change significantly in patients who stayed untreated (40.7 ng/L at first measurement and 37.1 ng/L at second measurement), initiated first-line treatment (20.6 ng/L vs 25.5 ng/L), or switched between first-line DMTs (17.3 ng/L vs 16.7 ng/L).

“The goal of DMTs in MS is to reduce axonal degeneration,” said Dr. Nováková. “Repeated analysis of serum NFL may represent a new possibility to monitor this process and may provide objective support in treatment decisions.”

 

PARIS—It is possible to gauge the effects of disease-modifying therapies (DMTs) for multiple sclerosis (MS) by measuring serum levels of neurofilament light (NFL), according to research presented at the Seventh Joint ECTRIMS–ACTRIMS Meeting. DMTs with greater efficacy appear to be associated with lower serum NFL concentrations.

NFL is a biomarker of axonal damage that has been measured primarily in CSF. In patients with MS, the CSF NFL concentration reflects disease activity and the efficacy of DMTs. Investigators recently developed an ultrasensitive immunoassay that can determine NFL levels in serum.

 To examine the effect of DMTs on serum NFL, Lenka Nováková, MD, a neurologist at Sahlgrenska University Hospital in Gothenburg, Sweden, and colleagues measured serum NFL concentrations in 98 patients with relapsing-remitting MS and 48 patients with progressive MS. Serum samples were obtained before and after treatment, with a median time interval of 12 months between measurements. During the interval, eight patients remained untreated, 10 initiated first-line treatment, 41 initiated second-line treatment, 67 escalated from first-line to second-line treatment, 17 switched from one second-line treatment to a different second-line treatment, two switched from a first-line treatment to a different first-line treatment, and one stopped treatment.

The investigators measured serum NFL concentrations using an in-house ultrasensitive single molecule array immunoassay. The intra-assay and inter-assay coefficient of variation was less than 10%.

Median serum NFL concentration decreased significantly in treatment-naïve patients who initiated second-line DMTs (ie, from 22.7 ng/L to 18.5 ng/L) or escalated from a first-line to a second-line DMT (ie, from 17.9 ng/L to 12.6 ng/L). The median serum NFL concentration was stable in patients who switched between second-line DMTs (14.9 ng/L before the switch and 13.7 ng/L after the switch). Similarly, the median serum NFL concentration did not change significantly in patients who stayed untreated (40.7 ng/L at first measurement and 37.1 ng/L at second measurement), initiated first-line treatment (20.6 ng/L vs 25.5 ng/L), or switched between first-line DMTs (17.3 ng/L vs 16.7 ng/L).

“The goal of DMTs in MS is to reduce axonal degeneration,” said Dr. Nováková. “Repeated analysis of serum NFL may represent a new possibility to monitor this process and may provide objective support in treatment decisions.”