Attitudes of Neurologists Toward Serum Neurofilament Light-Chain Testing in the Management of Relapsing–Remitting Multiple Sclerosis with Cognitive Impairment

Journal of Personalized Medicine, Journal Year: 2025, Volume and Issue: 15(2), P. 69 - 69

Published: Feb. 14, 2025

Background: Cognitive impairment has an impact upon the function and quality of life patients with multiple sclerosis (MS). High-serum neurofilament light-chain (sNfL) levels predict disease progression are also associated impaired cognitive performance. This study aimed to assess attitudes neurologists toward sNfL testing as regards making therapeutic decisions in clinically radiologically stable experiencing decline. Methods: A web-based observational was conducted among caring for MS. The role assessed through a simulated case scenario describing 31-year-old woman relapsing-remitting MS four years on glatiramer acetate. Her partner reported increased distractibility difficulties organizing daily activities over past 18 months. There no history new relapses, follow-up brain MRI scan showed lesions. performance Symbol Digit Modalities Test decreased by 8 points from previous year, 46 correct answers. patient had level 21 pg/mL, other identified factors that could have altered this value. participants were tasked deciding either escalate treatment or continue current schedule reassessment 6-12 months (defined misaligned emerging evidence [DMEE]). Multivariate regression analysis determine DMEE. Results: One hundred sixteen participated study. Almost 50% (n = 57) opted not despite high levels. more common fully dedicated care (60.5% vs. 43.6%). multivariate being neurologist (odds ratio [OR] 2.35, 95% confidence interval [CI] 1.01-5.50; p 0.04) having poor perception benefits (OR 1.02, CI 1.00-1.04; 0.01) Conclusions: Neurologists' lack full dedication limited sNfL's clinical utility key suboptimal decline elevated sNfL. These findings underscore need education improve evidence-based decision-making management.

Language: Английский

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Real-World Study of Serum Neurofilament Light Chain Levels in Ocrelizumab-Treated People with Relapsing Multiple Sclerosis

Journal of Personalized Medicine, Journal Year: 2024, Volume and Issue: 14(7), P. 692 - 692

Published: June 27, 2024

Serum neurofilament light chain (sNfL) levels have been proposed as a biomarker of the clinical activity, disability progression, and response to treatment people with multiple sclerosis (PwMS); however, questions remain about its implementation in practice. Ocrelizumab (OCR) has proven effective improving radiological outcomes reducing sNfL levels. This real-life study followed 30 PwMS treated for 12 months OCR evaluated usefulness this their short-term prognosis, considering expanded status scale (EDSS), annualized relapse rate (ARR), NEDA-3 values. reduced ARR 83% activity 80%. EDSS was maintained, while achieved 70% at months. produced an early reduction (at 3 months). At baseline, greater MRI-evaluated associated higher over first did not predict suboptimal or sustained control disease. Longer-term studies are needed explore predictive high-efficacy drugs.

Language: Английский

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The ocrelizumab wearing-off phenomenon is associated with reduced immunomodulatory response and increased neuroaxonal damage in multiple sclerosis

Journal of Neurology, Journal Year: 2024, Volume and Issue: 271(8), P. 5012 - 5024

Published: May 23, 2024

Abstract Objective The wearing-off phenomenon is common in people with multiple sclerosis (MS) treated ocrelizumab. We aim to evaluate the presence and severity of ocrelizumab relation demographic MS clinical variables, immune profiling, a marker neuroaxonal damage (plasma neurofilament light chain (pNfl)). Methods This cross-sectional study included patients from at least 1 year. Wearing-off questionnaire blood samples were collected between 21 23 weeks after previous infusion. Lymphocyte subpopulations evaluated on peripheral using flow cytometry. PNfl was fully automated chemiluminescent enzyme immunoassay. Results 106 (age 49.5 ± 11.6 years; females 42.3%; 57.6%). On regression models, associated higher pNfl, CD8, CD3, CD3CD27 lymphocytes. Most frequent symptoms cognitive, sensory, balance problems; started < week (9.4%), 1–4 (10.7%) or > 4 before infusion; 44.8% complaints moderate severe. Severity pNfl CD8 Conclusions ocrelizumab, reduced immunomodulation (higher T lymphocytes) increased damage, suggesting treatment response.

Language: Английский

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Real‐World Study of Serum Neurofilament Light Chain Levels in Ocrelizumab‐Treated People with Relapsing Multiple Sclerosis

Published: May 30, 2024

Serum neurofilament light chain (sNfL) levels have been proposed as a biomarker of the clinical activity, disability progression, and response to treatment people with multiple sclerosis (PwMS); however, questions remain about its implementation in practice. Ocrelizumab (OCR) has proven effective improve radiological outcomes reduce sNfL levels. This real-life study followed 30 PwMS treated for 12 months OCR evaluated usefulness this short-term prognosis, considering expanded status scale (EDSS), annualized relapse rate (ARR), NEDA-3 values. reduced ARR 83% activity 80%. Their EDSS was maintained, while achieved 70% at months. produced an early reduction (at 3 months). At baseline, greater MRI-evaluated associated higher sNFL over first did not predict suboptimal or sustained control disease. Longer-term studies are needed explore predictive high-efficacy drugs

Language: Английский

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Clinical utility of the Lumipulse™ immunoassay for plasma neurofilament light chain in multiple sclerosis

Journal of the Neurological Sciences, Journal Year: 2024, Volume and Issue: 463, P. 123115 - 123115

Published: June 27, 2024

Blood neurofilament light chain (NfL) is robustly associated with disease worsening in multiple sclerosis (MS), though potentially affected by concomitant factors also determining neuro-axonal loss. We investigated the association between plasma NfL (pNfL) measured Lumipulse™ immunoassay and demographic clinical variables MS.

Language: Английский

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Does serum neurofilament light chain measurement influence therapeutic decisions in multiple sclerosis?

Multiple Sclerosis and Related Disorders, Journal Year: 2024, Volume and Issue: 90, P. 105838 - 105838

Published: Aug. 23, 2024

Language: Английский

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