RT Journal Article
SR Electronic
T1 Monitoring of radiologic disease activity by serum neurofilaments in MS
JF Neurology - Neuroimmunology Neuroinflammation
JO Neurol Neuroimmunol Neuroinflamm
FD Lippincott Williams & Wilkins
SP e714
DO 10.1212/NXI.0000000000000714
VO 7
IS 4
A1 Uher, Tomas
A1 Schaedelin, Sabine
A1 Srpova, Barbora
A1 Barro, Christian
A1 Bergsland, Niels
A1 Dwyer, Michael
A1 Tyblova, Michaela
A1 Vodehnalova, Karolina
A1 Benkert, Pascal
A1 Oechtering, Johanna
A1 Leppert, David
A1 Naegelin, Yvonne
A1 Krasensky, Jan
A1 Vaneckova, Manuela
A1 Kubala Havrdova, Eva
A1 Kappos, Ludwig
A1 Zivadinov, Robert
A1 Horakova, Dana
A1 Kuhle, Jens
A1 Kalincik, Tomas
YR 2020
UL http://nn.neurology.org/content/7/4/e714.abstract
AB Objective To determine whether serum neurofilament light chain (sNfL) levels are associated with recent MRI activity in patients with relapsing-remitting MS (RRMS).Methods This observational study included 163 patients (405 samples) with early RRMS from the Study of Early interferon-beta1a (IFN-β1a) Treatment (SET) cohort and 179 patients (664 samples) with more advanced RRMS from the Genome-Wide Association Study of Multiple Sclerosis (GeneMSA) cohort. Based on annual brain MRI, we assessed the ability of sNfL cutoffs to reflect the presence of combined unique active lesions, defined as new/enlarging lesion compared with MRI in the preceding year or contrast-enhancing lesion. The probability of active MRI lesions among patients with different sNfL levels was estimated with generalized estimating equations models.Results From the sNfL samples ≥90th percentile, 81.6% of the SET (OR = 3.4, 95% CI = 1.8-6.4) and 48.9% of the GeneMSA cohort samples (OR = 2.6, 95% CI = 1.7-3.9) was associated with radiological disease activity on MRI. The sNfL level between the 10th and 30th percentile was reflective of negligible MRI activity: 1.4% (SET) and 6.5% (GeneMSA) of patients developed ≥3 active lesions, 5.8% (SET) and 6.5% (GeneMSA) developed ≥2 active lesions, and 34.8% (SET) and 11.8% (GeneMSA) showed ≥1 active lesion on brain MRI. The sNfL level <10th percentile was associated with even lower MRI activity. Similar results were found in a subgroup of clinically stable patients.Conclusions Low sNfL levels (≤30th percentile) help identify patients with MS with very low probability of recent radiologic disease activity during the preceding year. This result suggests that in future, sNfL assessment may substitute the need for annual brain MRI monitoring in considerable number (23.1%–36.4%) of visits in clinically stable patients.DMT=disease-modifying treatment; EDSS=Expanded Disability Status Scale; GeneMSA=Genome-Wide Association Study of Multiple Sclerosis; IFN-β1a=interferon-beta1a; NfL=neurofilament; RRMS=relapsing-remitting MS; SET=Study of Early interferon-beta1a (IFN-β1a) Treatment; sNfL=serum neurofilament light chain; T1-WI=T1-weighted image