- Patients with multiple sclerosis (MS) who have higher plasma levels of neurofilament light chain protein may be at increased risk for disability progression.
Why this matters
- Accurate prediction of clinical course using such testing can help inform counseling, treatment, and planning.
- Editorial: the findings confirm the prognostic value of this biomarker, but some questions remain, including how to reconcile assays and establish global cutoff values.
- Baseline median plasma neurofilament light chain level was 52% higher in patients with MS vs unaffected participants (11.4 vs 7.5 pg/mL; P<.001>
- With median 5-year follow-up, a high biomarker level using various age-stratified percentile cutoffs (80%, 95%, 99%) was linked to increased adjusted rates of:
- Expanded Disability Status Scale (EDSS) worsening within a year: 1.40-1.65.
- Reaching sustained EDSS score of 3.0: 1.50-1.55.
- Reaching sustained EDSS score of 4.0: 1.46-1.60.
- All P<.001.>
- No consistent significant associations were seen for reaching sustained EDSS score of 6.0, conversion to secondary progressive MS.
- Longitudinal cohort study of 4385 adult patients in Sweden with MS (predominantly relapsing-remitting) and 1026 randomly selected population-based sex- and age-matched unaffected participants.
- Main outcomes: disability progression.
- Funding: Swedish Research Council; Biogen; others.
- Variability, overlap of levels between patients and unaffected participants and by MS subtype.
- Inability to account for comorbidities.
- No long-term MRI data.
- Small number of patients reaching disability milestones.