Serum Neurofilament Light Chain Levels as a Biomarker of Disease Activity and Treatment Response in Patients with Progressive and Relapsing Multiple Sclerosis
Marzena Pedrini1, Belinda Kaskow1, Stephanie Trend1, William Carroll1, Susan Walters1, Aleksandra Maceski2, Jens Kuhle2, Allan Kermode3
1Perron Institute for Neurological and Translational Science, 2Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine, and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland, 3SJOG Clinic, Suite 314
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. 

10.1212/WNL.0000000000204284