Abstract
Objective:
To assess the value of serum neurofilament light chain (NfL) as a biomarker of disease activity and treatment response in Western Australian patients with multiple sclerosis (MS).
Background:
NfL is a less costly, blood-based biomarker suitable for the longitudinal monitoring of disease status and response to treatment. NfL levels in the CSF and blood are reflecting the degree of axonal damage in MS.
Design/Methods:
Serum NfL levels were measured in 542 patients with demyelinating disease, using single-molecule array technology (SIMOA). Treatment strategies were classified as “no treatment”, “injectable” and “high efficacy”. The Expanded Disability Status Scale (EDSS) score and patients’ demographics were also analysed.
Results:
Higher levels of NfL were associated with higher levels of disability. There was a statistically significant difference in NfL levels between early disease (CIS/RRMS) and progressive disease (PPMS/SPMS), without treatment (35.2 ± 4.5 vs 42.0 ± 3.9, p<0.01, adjusted for age). Therapy significantly reduced NfL levels in RRMS compared to “no treatment” (24.4 ± 1.3 vs 36.9 ± 5.1, p<0.01, adjusted for age). Both “injectable” and “high efficacy” therapies reduced serum NfL levels in RRMS patients, however, a statistically significant difference was noted only with “high efficacy” treatments (23.3 ± 1.5 vs 36.9 ±5.1).
Conclusions:
Our findings support the potential value of serum NfL as a measure of disease activity and treatment response in multiple sclerosis.