Smets, Ide; Holden, David; Bianchi, Lucia; Ammoscato, Francesca; Allen-Philbey, Kimberley; Baker, David; Turner, Benjamin; Marta, Monica; Giovannoni, Gavin; Macdougall, Amy; +3 more... Schmierer, Klaus; Hobart, Jeremy; Gnanapavan, Sharmilee; (2022) Factors contributing to CSF NfL reduction over time in those starting treatment for multiple sclerosis: An observational study. MULTIPLE SCLEROSIS AND RELATED DISORDERS, 57. 103409-. ISSN 2211-0348 DOI: https://doi.org/10.1016/j.msard.2021.103409
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Abstract
BACKGROUND: In multiple sclerosis (MS) neurofilament light chain (NfL) is a marker of neuronal damage secondary to inflammation and neurodegeneration. NfL levels drop after commencement of disease-modifying treatment, especially the highly active ones. However, the factors that influence this drop are unknown. OBJECTIVE: To examine the patient and treatment-related factors that influence CSF NfL before and after starting treatment. METHODS: Eligible patients across two centres with two CSF NfL measurements, clinical and MRI data were included as part of an observational cohort study. RESULTS: Data were available in 61 patients, of which 40 were untreated at the first CSF sampling (T1) and treated at the second (T2; mean T1-T2: 19 months). CSF NfL reduction correlated with age (beta = 1.24 95%CI(1.07,1.43); R2 = 0.17; p = 0.005), Expanded Disability Status Scale (EDSS) (beta = 1.12 95%CI(1.00,1.25); R2 = 0.21; p = 0.05) and the type of MS (beta = 0.63 95%CI(0.43, 0.92); R2 = 0.12; p = 0.018; reference=relapsing MS). The treatment effect on a baseline NfL of 702 pg/mL was 451 pg/ml 95%CI(374,509) in a 30-year-old versus 228 pg/ml 95%CI(63,350) in a 60-year-old. There was no association in CSF NfL reduction with BMI, disease duration or sex. In cladribine- and alemtuzumab-treated patients, the CSF NfL T2/T1 ratio did not correlate with lymphocyte depletion rate at 23 weeks. CONCLUSIONS: In this observational study, we found that factors reflecting early disease stage, including a younger age, lower disability and relapsing MS were associated with treatment response in CSF NfL. Other factors were not found to be related, including lymphopaenia in highly-active treatments.
Item Type | Article |
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Faculty and Department | Faculty of Epidemiology and Population Health > Dept of Medical Statistics |
PubMed ID | 34871856 |
Elements ID | 168663 |
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Filename: Smets_etal_2022_Factors-contributing-to-CSF-NfL.pdf
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