Temporal Relationship Between Serum Neurofilament Light Chain and Radiologic Disease Activity in Patients With Multiple Sclerosis

. 2024 May 14 ; 102 (9) : e209357. [epub] 20240422

Jazyk angličtina Země Spojené státy americké Médium print-electronic

Typ dokumentu časopisecké články, randomizované kontrolované studie, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/pmid38648580

BACKGROUND AND OBJECTIVES: Serum neurofilament light chain (sNfL) levels correlate with multiple sclerosis (MS) disease activity, but the dynamics of this correlation are unknown. We evaluated the relationship between sNfL levels and radiologic MS disease activity through monthly assessments during the 24-week natalizumab treatment interruption period in RESTORE (NCT01071083). METHODS: In the RESTORE trial, participants with relapsing forms of MS who had received natalizumab for ≥12 months were randomized to either continue or stop natalizumab and followed with MRI and blood draws every 4 weeks to week 28 and again at week 52 The sNfL was measured, and its dynamics were correlated with the development of gadolinium-enhancing (Gd+) lesions. Log-linear trend in sNfL levels were modeled longitudinally using generalized estimating equations with robust variance estimator from baseline to week 28. RESULTS: Of 175 patients enrolled in RESTORE, 166 had serum samples for analysis. Participants with Gd+ lesions were younger (37.7 vs 43.1, p = 0.001) and had lower Expanded Disability Status Scale scores at baseline (2.7 vs 3.4, p = 0.017) than participants without Gd+ lesions. sNfL levels increased in participants with Gd+ lesions (n = 65) compared with those without (n = 101, mean change from baseline to maximum sNfL value, 12.1 vs 3.2 pg/mL, respectively; p = 0.003). As the number of Gd+ lesions increased, peak median sNfL change also increased by 1.4, 3.0, 4.3, and 19.6 pg/mL in the Gd+ lesion groups of 1 (n = 12), 2-3 (n = 18), 4-9 (n = 21), and ≥10 (n = 14) lesions, respectively. However, 46 of 65 (71%) participants with Gd+ lesions did not increase above the 95th percentile threshold of the group without Gd+ lesions. The initial increase of sNfL typically trailed the first observation of Gd+ lesions, and the peak increase in sNfL was a median [interquartile range] of 8 [0, 12] weeks after the first appearance of the Gd+ lesion. DISCUSSION: Although sNfL correlated with the presence of Gd+ lesions, most participants with Gd+ lesions did not have elevations in sNfL levels. These observations have implications for the use and interpretation of sNfL as a biomarker for monitoring MS disease activity in controlled trials and clinical practice.

Komentář v

PubMed

Zobrazit více v PubMed

Thompson AJ, Banwell BL, Barkhof F, et al. . Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17(2):162-173. doi:10.1016/S1474-4422(17)30470-2 PubMed DOI

Wattjes MP, Ciccarelli O, Reich DS, et al. . Magnetic Resonance Imaging in Multiple Sclerosis study group, Consortium of Multiple Sclerosis Centres, North American Imaging in Multiple Sclerosis Cooperative MRI guidelines working group. 2021 MAGNIMS-CMSC-NAIMS consensus recommendations on the use of MRI in patients with multiple sclerosis. Lancet Neurol. 2021;20(8):653-670. doi:10.1016/S1474-4422(21)00095-8 PubMed DOI

Tomassini V, Sinclair A, Sawlani V, et al. . Diagnosis and management of multiple sclerosis: MRI in clinical practice. J Neurol. 2020;267(10):2917-2925. doi:10.1007/s00415-020-09930-0 PubMed DOI PMC

Yuan A, Rao MV, Veeranna, Nixon RA. Neurofilaments and neurofilament proteins in health and disease. Cold Spring Harb Perspect Biol. 2017;9(4):a018309. doi:10.1101/cshperspect.a018309 PubMed DOI PMC

Ferreira-Atuesta C, Reyes S, Giovanonni G, Gnanapavan S. The evolution of neurofilament light chain in multiple sclerosis. Front Neurosci. 2021;15:642384. doi:10.3389/fnins.2021.642384 PubMed DOI PMC

Kuhle J, Barro C, Disanto G, et al. . Serum neurofilament light chain in early relapsing remitting MS is increased and correlates with CSF levels and with MRI measures of disease severity. Mult Scler. 2016;22(12):1550-1559. doi:10.1177/1352458515623365 PubMed DOI

Disanto G, Barro C, Benkert P, et al. . Serum Neurofilament light: a biomarker of neuronal damage in multiple sclerosis. Ann Neurol. 2017;81(6):857-870. doi:10.1002/ana.24954 PubMed DOI PMC

Novakova L, Zetterberg H, Sundstrom P, et al. . Monitoring disease activity in multiple sclerosis using serum neurofilament light protein. Neurology. 2017;89(22):2230-2237. doi:10.1212/WNL.0000000000004683 PubMed DOI PMC

Kuhle J, Plavina T, Barro C, et al. . Neurofilament light levels are associated with long-term outcomes in multiple sclerosis. Mult Scler. 2020;26(13):1691-1699. doi:10.1177/1352458519885613 PubMed DOI PMC

Cantó E, Barro C, Zhao C, et al. . Association between serum neurofilament light chain levels and long-term disease course among patients with multiple sclerosis followed up for 12 years. JAMA Neurol. 2019;76(11):1359-1366. doi:10.1001/jamaneurol.2019.2137 PubMed DOI PMC

Fox RJ, Cree BA, De Seze J, et al. . MS disease activity in RESTORE: a randomized 24-week natalizumab treatment interruption study. Neurology. 2014;82(17):1491-1498. doi:10.1212/WNL.0000000000000355 PubMed DOI PMC

Ryerson LZ, Foley J, Chang I, et al. . Risk of natalizumab-associated PML in patients with MS is reduced with extended interval dosing. Neurology. 2019;93(15):e1452-e1462. doi:10.1212/WNL.0000000000008243 PubMed DOI PMC

Chisari CG, Grimaldi LM, Salemi G, et al. .; Italian MS Register Study Group. Clinical effectiveness of different natalizumab interval dosing schedules in a large Italian population of patients with multiple sclerosis. J Neurol Neurosurg Psychiatry. 2020;91(12):1297-1303. doi:10.1136/jnnp-2020-323472 PubMed DOI

Butzkueven H, Kappos L, Spelman T, et al. . No evidence for loss of natalizumab effectiveness with every-6-week dosing: a propensity score-matched comparison with every-4-week dosing in patients enrolled in the Tysabri Observational Program (TOP). Ther Adv Neurol Disord. 2021;14:17562864211042458. doi:10.1177/17562864211042458 PubMed DOI PMC

Ryerson LZ, Naismith RT, Krupp LB, et al. . No difference in radiologic outcomes for natalizumab patients treated with extended interval dosing compared with standard interval dosing: real-world evidence from MS PATHS. Mult Scler Relat Disord. 2022;58:103480. doi:10.1016/j.msard.2021.103480 PubMed DOI

Kapoor R, Sellebjerg F, Hartung H, et al. . Natalizumab reduces serum concentrations of neurofilament light chain in secondary progressive multiple sclerosis patients from the phase 3 ASCEND study (S12.008). Neurology. 2019;92(15_supplement):S12-S008. doi:10.1212/wnl.92.15_supplement.s12.008 DOI

Gafson AR, Jiang X, Shen C, et al. . Serum neurofilament light and multiple sclerosis progression independent of acute inflammation. JAMA Netw Open. 2022;5(2):e2147588. doi:10.1001/jamanetworkopen.2021.47588 PubMed DOI PMC

Sotirchos ES, Fitzgerald KC, Singh CM, et al. . Associations of sNfL with clinico-radiological measures in a large MS population. Ann Clin Transl Neurol. 2023;10(1):84-97. doi:10.1002/acn3.51704 PubMed DOI PMC

Nejnovějších 20 citací...

Zobrazit více v
Medvik | PubMed

MS treatment de-escalation: review and commentary

. 2024 Oct ; 271 (10) : 6426-6438. [epub] 20240802

Zobrazit více v PubMed

ClinicalTrials.gov
NCT01071083

Najít záznam

Citační ukazatele

Nahrávání dat ...

Možnosti archivace

Nahrávání dat ...