Abstract Details

Despite the increased availability of efficient therapeutic options, effective biological tools are still mandatory for individualized clinical management in MS. Neurofilament light chain (NfL) is the most promising biomarker of disease activity and treatment efficacy, but its implementation in clinical practice is still to be addressed.

To evaluate the use of sNFL in Multiple Sclerosis (MS) clinical practice, as measure of disease activity and treatment efficacy, in particular within NEDA assessment.

sNFL were cross-sectionally evaluated in 961 MS patients (830 relapsing remitting (RR), 53 primary progressive (PP) and 78 secondary progressive(SP)) at different disease stages including diagnostic time, immediately before treatment, and during treatment with the main disease modifying treatments (DMTs). sNFL were correlated with radiological and clinical activity, and evaluated in a subgroup of 521 treated RR patients in NEDA-3 status.

sNFL were measured by Simoa assay (Quanterix) and interpreted according to previously defined cut-off values. Samples and data were collected within CRESM Biobank.

1) Progressive MS patients showed a greater prevalence of pathological sNFL levels (32% in PPMS and 26% in SPMS) relative to RRMS (16%). 2) All DMTs notably lowered sNF-L relative to naïve patients. 3) pathological sNFL levels were observed in 72-75% of clinical and radiological active patients respectively, but also in 10% of NEDA-3 patients: this percentage lowered with extension of NEDA-3 status duration. These patients were classified according to their different clinical characteristics.

Our study shows that sNFL use in everyday clinical practice could be informative in the individual monitoring of MS patients and in NEDA assessment.

Previously defined cut-offs were applied to discriminate patients’ samples in different contexts, showing correlation with disease subtype, clinical activity and DMTs efficacy.