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| Item Type: | Article |
|---|---|
| Title: | Clinical implications of serum neurofilament in newly diagnosed MS patients: a longitudinal multicentre cohort study |
| Creators Name: | Bittner, S. and Steffen, F. and Uphaus, T. and Muthuraman, M. and Fleischer, V. and Salmen, A. and Luessi, F. and Berthele, A. and Klotz, L. and Meuth, S.G. and Bayas, A. and Paul, F. and Hartung, H.P. and Linker, R. and Heesen, C. and Stangel, M. and Wildemann, B. and Then Bergh, F. and Tackenberg, B. and Kuempfel, T. and Weber, F. and Zettl, U.K. and Ziemann, U. and Tumani, H. and Groppa, S. and Mühlau, M. and Lukas, C. and Hemmer, B. and Wiendl, H. and Gold, R. and Zipp, F. |
| Abstract: | BACKGROUND: We aim to evaluate serum neurofilament light chain (sNfL), indicating neuroaxonal damage, as a biomarker at diagnosis in a large cohort of early multiple sclerosis (MS) patients. METHODS: In a multicentre prospective longitudinal observational cohort, patients with newly diagnosed relapsing-remitting MS (RRMS) or clinically isolated syndrome (CIS) were recruited between August 2010 and November 2015 in 22 centers. Clinical parameters, MRI, and sNfL levels (measured by single molecule array) were assessed at baseline and up to four-year follow-up. FINDINGS: Of 814 patients, 54.7% (445) were diagnosed with RRMS and 45.3% (369) with CIS when applying 2010 McDonald criteria (RRMS[2010] and CIS[2010]). After reclassification of CIS[2010] patients with existing CSF analysis, according to 2017 criteria, sNfL levels were lower in CIS[2017] than RRMS[2017] patients (9.1 pg/ml, IQR 6.2-13.7 pg/ml, n = 45; 10.8 pg/ml, IQR 7.4-20.1 pg/ml, n = 213; p = 0.036). sNfL levels correlated with number of T2 and Gd+ lesions at baseline and future clinical relapses. Patients receiving disease-modifying therapy (DMT) during the first four years had higher baseline sNfL levels than DMT-naïve patients (11.8 pg/ml, IQR 7.5-20.7 pg/ml, n = 726; 9.7 pg/ml, IQR 6.4-15.3 pg/ml, n = 88). Therapy escalation decisions within this period were reflected by longitudinal changes in sNfL levels. INTERPRETATION: Assessment of sNfL increases diagnostic accuracy, is associated with disease course prognosis and may, particularly when measured longitudinally, facilitate therapeutic decisions. |
| Keywords: | Neurofilament Light Chain, sNfL, Multiple Sclerosis, Prediction, Biomarker |
| Source: | EBioMedicine |
| ISSN: | 2352-3964 |
| Publisher: | Elsevier |
| Volume: | 56 |
| Page Range: | 102807 |
| Date: | June 2020 |
| Additional Information: | Erratum in: EBioMedicine 66: 103295. |
| Official Publication: | https://doi.org/10.1016/j.ebiom.2020.102807 |
| PubMed: | View item in PubMed |
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