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

• Published in: Journal of neurology 2024-12, Vol.271 (12), p.7494-7501
• Main Authors: Malucchi, Simona, Bava, Cecilia Irene, Valentino, Paola, Martire, Serena, Lo Re, Marianna, Bertolotto, Antonio, Di Sapio, Alessia
• Format: Article
• Language: English
• Subjects: Adult; Biomarkers - blood; Blood levels; Cerebrospinal fluid; Cytoskeleton; Disability Evaluation; Disease Progression; Dosage; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Multiple sclerosis; Multiple Sclerosis - blood; Multiple Sclerosis - diagnostic imaging; Multiple Sclerosis, Relapsing-Remitting - blood; Multiple Sclerosis, Relapsing-Remitting - diagnostic imaging; Multiple Sclerosis, Relapsing-Remitting - drug therapy; Neurofilament Proteins - blood; Neurofilament Proteins - cerebrospinal fluid; Neuroimaging; Neurology; Neuroradiology; Neurosciences; Original Communication; Regression analysis
• ISSN: 0340-5354; 1432-1459; 1432-1459
• DOI: 10.1007/s00415-024-12701-w

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