Abstract:
Serum neurofilament light chain (sNfL) levels have been proposed as a biomarker of the clinical activity, disability progression, and response to treatment of people with multiple sclerosis (PwMS); however, questions remain about its implementation in clinical practice. Ocrelizumab (OCR) has proven effective in improving clinical and radiological outcomes and reducing sNfL levels. This real-life study followed the sNfL levels of 30 PwMS treated for 12 months with OCR and evaluated the usefulness of this biomarker for their short-term prognosis, considering expanded disability status scale (EDSS), annualized relapse rate (ARR), radiological activity, and NEDA-3 values. OCR reduced ARR in 83% of PwMS and radiological activity in 80%. EDSS was maintained, while NEDA-3 was achieved in 70% at 12 months. OCR produced an early reduction in sNfL levels (at 3 months). At baseline, greater MRI-evaluated radiological activity was associated with higher sNfL levels. sNfL levels over the first 12 months of treatment did not predict a suboptimal response or sustained control of the disease. Longer-term studies are needed to explore the predictive usefulness of sNfL levels in PwMS treated with high-efficacy drugs.
摘要:
血清神经丝轻链(sNfL)水平已被提出作为临床活性的生物标志物,残疾进展,和对多发性硬化症(PwMS)患者的治疗反应;然而,在临床实践中的实施仍然存在疑问。Ocrelizumab(OCR)已被证明可有效改善临床和放射学结果并降低sNfL水平。这项现实生活中的研究跟踪了用OCR治疗12个月的30PwMS的sNfL水平,并评估了这种生物标志物对其短期预后的有用性。考虑扩展的残疾状况量表(EDSS),年复发率(ARR),放射性活动,和NEDA-3值。OCR降低了83%的PwMS的ARR和80%的放射活性。EDSS被维护,而NEDA-3在12个月时实现了70%。OCR产生sNfL水平的早期降低(在3个月时)。在基线,MRI评估的放射学活动越大,sNfL水平越高.治疗前12个月的sNfL水平并不能预测疾病的缓解或持续控制。需要更长期的研究来探索sNfL水平在使用高效药物治疗的PwMS中的预测有效性。