Starting treatment with a disease-modifying therapy (DMT) reduces blood levels of neurofilament light chain (NfL) — a potential biomarker of disease progression and activity — to varying degrees depending on the therapy used, according to a large real-world study of patients with relapsing-remitting multiple sclerosis (RRMS).
The findings support the potential of plasma NfL as a treatment response marker, useful for monitoring the effectiveness of MS therapies and see how well they are working for patients, researchers said.
The study “Blood neurofilament light levels segregate treatment effects in multiple sclerosis,” was published in the journal Neurology.
Neurofilaments are nerve cell-specific components that can be released upon nerve cell damage or death (neurodegeneration). Neurofilament light chains (NfL) can be measured in different body compartments, and have emerged as promising biomarkers of neurological diseases, including MS.
NfL levels above a certain threshold in the cerebrospinal fluid (the fluid that bathes the brain and spinal cord) or in blood have been proposed as potential biomarkers of MS progression, disease activity, and response to treatment.
The potential value of NfL as a marker for MS “is especially high,” researchers wrote, since it may detect changes over shorter periods of time that are beyond reach through standard magnetic resonance imaging (MRI).
Most studies testing NfL as a marker of treatment response have measured it in the cerebrospinal fluid, but recent improvements in assay (test) sensitivity have made it possible to reliably determine NfL in blood — either in serum (sNfL) or plasma (pNfL).
However, the available studies focusing on blood NfL are underpowered to specifically address treatment effects across multiple DMTs in real-world practice.
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