Abstract: 12
Type: Educational Session
Abstract Category: N/A
Multiple sclerosis (MS) is characterized by focal white matter inflammation in the brain and spinal cord. Such lesions can be visualized with magnetic resonance imaging (MRI), the only established biomarker of disease activity in clinical routine today. However, it is evident that also grey and normal appearing white matter are affected in MS; pathology for which standard MRI techniques are less sensitive. Hence, fluid biomarkers could be highly useful to assess important disease processes such as neuro-axonal degeneration, arguably the most important determinant for long term disability. Accumulating evidence suggests that the neurofilament light chain (NfL) could serve this purpose, since early studies in MS demonstrated significant correlations between the cerebrospinal fluid (CSF) NfL concentration and degree of disability and relapse rates. Initial findings have been replicated and extended by subsequent studies, including also effects by disease modulatory treatments, suggesting that NfL can be used to monitor therapeutic efficacy. Still, a major barrier for a more widespread adoption of NfL in research and clinical practice has been the requirement of CSF sampling. Only very recently sufficiently sensitive assays to allow for detection of serum NfL have been developed, sparking a much wider interest in NfL as a tool to characterize disease activity at diagnosis, but also to follow treatment efficacy in individual MS patients. However, issues such as the predictive power for long term disability, frequency of blood sampling and the relevance in progressive MS still needs to be addressed more in detail before its clinical usefulness can be determined. In this presentation the clinical applications of today and tomorrow will be discussed, also in the context of other biomarkers of disease activity, as well as the experiences in the Nordic countries of CSF NfL measurements in clinical routine.
Disclosure: FP has received research grants from Biogen, Novartis, and Genzyme, and fees for serving as Chair of DMC in clinical trials with Parexel.
Abstract: 12
Type: Educational Session
Abstract Category: N/A
Multiple sclerosis (MS) is characterized by focal white matter inflammation in the brain and spinal cord. Such lesions can be visualized with magnetic resonance imaging (MRI), the only established biomarker of disease activity in clinical routine today. However, it is evident that also grey and normal appearing white matter are affected in MS; pathology for which standard MRI techniques are less sensitive. Hence, fluid biomarkers could be highly useful to assess important disease processes such as neuro-axonal degeneration, arguably the most important determinant for long term disability. Accumulating evidence suggests that the neurofilament light chain (NfL) could serve this purpose, since early studies in MS demonstrated significant correlations between the cerebrospinal fluid (CSF) NfL concentration and degree of disability and relapse rates. Initial findings have been replicated and extended by subsequent studies, including also effects by disease modulatory treatments, suggesting that NfL can be used to monitor therapeutic efficacy. Still, a major barrier for a more widespread adoption of NfL in research and clinical practice has been the requirement of CSF sampling. Only very recently sufficiently sensitive assays to allow for detection of serum NfL have been developed, sparking a much wider interest in NfL as a tool to characterize disease activity at diagnosis, but also to follow treatment efficacy in individual MS patients. However, issues such as the predictive power for long term disability, frequency of blood sampling and the relevance in progressive MS still needs to be addressed more in detail before its clinical usefulness can be determined. In this presentation the clinical applications of today and tomorrow will be discussed, also in the context of other biomarkers of disease activity, as well as the experiences in the Nordic countries of CSF NfL measurements in clinical routine.
Disclosure: FP has received research grants from Biogen, Novartis, and Genzyme, and fees for serving as Chair of DMC in clinical trials with Parexel.