Contributions
Abstract: EP1595
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 25 Biomarkers
The presence of elevated levels of neurofilament light chain (NFL) in the cerebrospinal fluid (CSF) is an indicator of axonal damage in the Central Nervous System (CNS) and has been tested as a biomarker in Multiple Sclerosis (MS). However, its value to predict disease course and to assist in therapeutic management still needs further confirmation.
In this study, our goal was to evaluate the usefulness of CSF NFL to predict disease severity in Relapsing-Remitting MS (RRMS) patients followed up to 10 years (6.5±3.3 years).
The study population comprised 39 RRMS patients and a control group consisting of 17 patients with non-inflammatory neurological diseases. In RRMS patients, evidence of active disease during follow-up (EDA) was evaluated through the occurrence of relapses, brain magnetic resonance imaging MRI activity or EDSS worsening. All patients received immunomodulatory treatment during follow-up: 20 underwent first line treatments (β-Interferon and Glatiramer Acetate); while 19, with a more aggressive disease course, were submitted to second line therapies (Natalizumab, Rituximab and Fingolimod). CSF samples were collected at time of diagnosis and NFL baseline levels were measured using an ELISA kit (Uman Diagnostics AB, Sweden).
There were no significant differences between RRMS patients and controls neither regarding age nor gender, but NFL levels were significantly higher in patients (2532±2237 vs. 896±932 pg/mL; p=0.0011). Regarding RRMS patients, no correlation was found between baseline NFL levels and EDSS score at lumbar puncture (LP) or at follow-up. However, we found increased baseline CSF NFL levels in patients with EDA compared to those not showing signs of active disease (3129±2061 vs. 2048±2440 pg/mL, p=0.038). Moreover, patients submitted to second line treatment during follow-up, had significantly higher baseline CSF NFL levels than patients that only underwent first line treatment (3305±2496 vs. 1759±1680 pg/mL, p=0.022). In fact, in a logistic regression analysis (including age of onset, gender, IgG oligoclonal bands, disease duration, EDSS at LP), baseline NFL levels was the only variable that could significantly predict, with 84% accuracy, the need for undergoing second-line therapy (p=0.022).
This study demonstrates the potential prognostic value of baseline CSF NFL in RRMS baseline CSF and supports its use as a guiding tool for long-term management of the disease.
Disclosure: Source of funding: This work was supported by Sanofi Genzyme.
Maria Joao Leitao: Nothing to disclose
Rui Pascoal: Nothing to disclose
Maria Helena Ribeiro: Nothing to disclose
Ines Correia: Nothing to disclose
Sonia Batista: Nothing to disclose
Livia Sousa: Nothing to disclose
Ines Baldeiras: Nothing to disclose
Abstract: EP1595
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 25 Biomarkers
The presence of elevated levels of neurofilament light chain (NFL) in the cerebrospinal fluid (CSF) is an indicator of axonal damage in the Central Nervous System (CNS) and has been tested as a biomarker in Multiple Sclerosis (MS). However, its value to predict disease course and to assist in therapeutic management still needs further confirmation.
In this study, our goal was to evaluate the usefulness of CSF NFL to predict disease severity in Relapsing-Remitting MS (RRMS) patients followed up to 10 years (6.5±3.3 years).
The study population comprised 39 RRMS patients and a control group consisting of 17 patients with non-inflammatory neurological diseases. In RRMS patients, evidence of active disease during follow-up (EDA) was evaluated through the occurrence of relapses, brain magnetic resonance imaging MRI activity or EDSS worsening. All patients received immunomodulatory treatment during follow-up: 20 underwent first line treatments (β-Interferon and Glatiramer Acetate); while 19, with a more aggressive disease course, were submitted to second line therapies (Natalizumab, Rituximab and Fingolimod). CSF samples were collected at time of diagnosis and NFL baseline levels were measured using an ELISA kit (Uman Diagnostics AB, Sweden).
There were no significant differences between RRMS patients and controls neither regarding age nor gender, but NFL levels were significantly higher in patients (2532±2237 vs. 896±932 pg/mL; p=0.0011). Regarding RRMS patients, no correlation was found between baseline NFL levels and EDSS score at lumbar puncture (LP) or at follow-up. However, we found increased baseline CSF NFL levels in patients with EDA compared to those not showing signs of active disease (3129±2061 vs. 2048±2440 pg/mL, p=0.038). Moreover, patients submitted to second line treatment during follow-up, had significantly higher baseline CSF NFL levels than patients that only underwent first line treatment (3305±2496 vs. 1759±1680 pg/mL, p=0.022). In fact, in a logistic regression analysis (including age of onset, gender, IgG oligoclonal bands, disease duration, EDSS at LP), baseline NFL levels was the only variable that could significantly predict, with 84% accuracy, the need for undergoing second-line therapy (p=0.022).
This study demonstrates the potential prognostic value of baseline CSF NFL in RRMS baseline CSF and supports its use as a guiding tool for long-term management of the disease.
Disclosure: Source of funding: This work was supported by Sanofi Genzyme.
Maria Joao Leitao: Nothing to disclose
Rui Pascoal: Nothing to disclose
Maria Helena Ribeiro: Nothing to disclose
Ines Correia: Nothing to disclose
Sonia Batista: Nothing to disclose
Livia Sousa: Nothing to disclose
Ines Baldeiras: Nothing to disclose