Contributions
Abstract: EP1680
Type: Poster Sessions
Abstract Category: Therapy - Tools for detecting therapeutic response
Introduction: Evidence suggests people with progressive multiple sclerosis (pwPMS) may benefit from immunomodulatory disease modifying treatment (DMT). However, only one such treatment (ocrelizumab) has been licensed. The difficulty assessing treatment outcome in pwPMS may be an important cause for the lack of respective DMT. The concentration of neurofilaments in the cerebrospinal fluid provides a substrate of neuro-axonal damage, and both neurofilament light (NfL) and heavy chain levels have been used as outcome indices, and to guide treatment choices.
Objectives: We explored the value of NfL as a marker for treatment success in pwPMS treated with cladribine.
Methods: Here, we report our experience treating two pwPMS with subcutaneous cladribine undergoing cerebrospinal fluid (CSF) Nfl testing, alongside MRI and clinical follow-up, before and after treatment.
Results: CSF samples obtained before and after treatment revealed substantial reduction of NfL levels in both cases (from 1700pg/ml to 453pg/ml in case 1, and from >10.000pg/ml to 525pg/ml in case 2), corroborating the MRI detectable drop in disease activity.
Conclusions: The level of NfL seems to be a sensitive index of treatment success in pwPMS. Cladribine, or the oral prodrug preparation (Mavenclad®) that has recently been licensed (in Europe) for relapsing MS, may be an effective treatment option for people at an advanced stage of MS.
Disclosure: Ozlem Yildiz, Zhifeng Mao, Ashok Adams, Dubuisson Nicolas, Kimberley Allen-Philbey, Andrea Malaspina, David Baker: nothing to disclose.
Sharmilee Gnanapavan has received travel support and consultancy fees from Biogen, Novartis, Teva, Pfizer, and support from Sanofi-Genzyme and Takeda.
Gavin Giovannoni has received fees for participation in advisory board for AbbVie Biotherapeutics, Biogen, Canbex, Ironwood, Novartis, Merck, Merck Serono, Roche, Sanofi Genzyme, Synthon, Teva and Vertex; speaker fees from AbbVie, Biogen, Bayer HealthCare, Genzyme, Merck Serono, Sanofi-Aventis and Teva. Research support from Biogen, Genzyme, Ironwood, Merck, Merck Serono, Novartis and Takeda.
Klaus Schmierer has been a principal investigator of trials sponsored by Medday, Novartis, Roche and Teva and involved in trials sponsored by Biogen, Sanofi-Genzyme, BIAL, Cytokinetics, and Canbex; has received research support from Biogen and Novartis, and honoraria and meeting support from Biogen, Lipomed, Merck Serono, Novartis, Roche and Teva.
Abstract: EP1680
Type: Poster Sessions
Abstract Category: Therapy - Tools for detecting therapeutic response
Introduction: Evidence suggests people with progressive multiple sclerosis (pwPMS) may benefit from immunomodulatory disease modifying treatment (DMT). However, only one such treatment (ocrelizumab) has been licensed. The difficulty assessing treatment outcome in pwPMS may be an important cause for the lack of respective DMT. The concentration of neurofilaments in the cerebrospinal fluid provides a substrate of neuro-axonal damage, and both neurofilament light (NfL) and heavy chain levels have been used as outcome indices, and to guide treatment choices.
Objectives: We explored the value of NfL as a marker for treatment success in pwPMS treated with cladribine.
Methods: Here, we report our experience treating two pwPMS with subcutaneous cladribine undergoing cerebrospinal fluid (CSF) Nfl testing, alongside MRI and clinical follow-up, before and after treatment.
Results: CSF samples obtained before and after treatment revealed substantial reduction of NfL levels in both cases (from 1700pg/ml to 453pg/ml in case 1, and from >10.000pg/ml to 525pg/ml in case 2), corroborating the MRI detectable drop in disease activity.
Conclusions: The level of NfL seems to be a sensitive index of treatment success in pwPMS. Cladribine, or the oral prodrug preparation (Mavenclad®) that has recently been licensed (in Europe) for relapsing MS, may be an effective treatment option for people at an advanced stage of MS.
Disclosure: Ozlem Yildiz, Zhifeng Mao, Ashok Adams, Dubuisson Nicolas, Kimberley Allen-Philbey, Andrea Malaspina, David Baker: nothing to disclose.
Sharmilee Gnanapavan has received travel support and consultancy fees from Biogen, Novartis, Teva, Pfizer, and support from Sanofi-Genzyme and Takeda.
Gavin Giovannoni has received fees for participation in advisory board for AbbVie Biotherapeutics, Biogen, Canbex, Ironwood, Novartis, Merck, Merck Serono, Roche, Sanofi Genzyme, Synthon, Teva and Vertex; speaker fees from AbbVie, Biogen, Bayer HealthCare, Genzyme, Merck Serono, Sanofi-Aventis and Teva. Research support from Biogen, Genzyme, Ironwood, Merck, Merck Serono, Novartis and Takeda.
Klaus Schmierer has been a principal investigator of trials sponsored by Medday, Novartis, Roche and Teva and involved in trials sponsored by Biogen, Sanofi-Genzyme, BIAL, Cytokinetics, and Canbex; has received research support from Biogen and Novartis, and honoraria and meeting support from Biogen, Lipomed, Merck Serono, Novartis, Roche and Teva.