In multiple sclerosis patients a single serum neurofilament light chain (sNFL) dosage is strongly associated with 12 months outcome: data from a real-life clinical setting. in Journal of neurology / J Neurol. 2024 Sep 23. doi: 10.1007/s00415-024-12701-w.
2024
AOU San Luigi di Orbassano
Tipo pubblicazione
Journal Article
Autori/Collaboratori (7)Vedi tutti...
Malucchi S
Department of Neurology and CRESM, University Hospital San Luigi Gonzaga, Regione Gonzole 10, 10043, Orbassano, Italy. simona.malucchi@gmail.com.
Bava CI
NICO-Neuroscience Institute Cavalieri Ottolenghi, Orbassano, Italy.
Valentino P
NICO-Neuroscience Institute Cavalieri Ottolenghi, Orbassano, Italy.
et alii...
Abstract
BACKGROUND: Neurofilament light chain (NFL) is a neuroaxonal cytoskeletal protein released into cerebrospinal fluid (CSF) and eventually into blood upon neuronal injury. Its detection in serum (sNFL) makes it a promising marker in multiple sclerosis (MS). OBJECTIVE: To evaluate the usefulness of a single dosage of sNFL in clinical practice. METHODS: 626 consecutive relapsing-remitting (RR) MS patients treated with disease modifying treatments (DMTs) for at least 12 months underwent a single sNFL dosage. 553 patients had NEDA-3 status (no relapses, no disability progression, no new/enlarging or contrast-enhancing lesions on brain magnetic resonance imaging) in the 12 months prior blood sampling. sNFL levels were measured by single molecule array (Simoa™). Association between sNFL levels and NEDA-3 status at 12, 24, and 36 months was evaluated with logistic regression models adjusted for sex, EDSS, disease duration, and type of DMTs. RESULTS: 469 out of the 553 NEDA-3 patients had normal sNFL level, whereas 42 had elevated level. The two groups did not differ regarding baseline characteristics. A very strong association between elevated sNFL levels and loss of NEDA-3 status within 12 months was found, with an odds ratio [OR] of 10.74 (95% CI 4.34-26.57); 15 and 10 patients with normal and elevated sNFL, respectively lost NEDA-3 (p?0.001). The effect was not detected during the subsequent 13-24 and 25-36 months. CONCLUSIONS: A single elevated sNFL is strongly associated with NEDA-3 loss within 1 year. Elevated sNFL in apparently stable patients suggests an ongoing disease activity below the detection threshold of standard parameters.
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PMID : 39313638
DOI : 10.1007/s00415-024-12701-w
Keywords
Fluid biomarkers; NEDA-3; Patients’ monitoring; SNFL;