Abstract Details

Title Serum neurofilament light chain association with progression independent of activity in people with early RRMS

Topic Multiple Sclerosis

Presentation(s) S9 - MS Biomarkers, Immunology, and Basic Science (4:18 PM-4:30 PM)

Poster/Presentation
Number 005

Background Serum neurofilament light chain (sNfL) is a marker of neuronal injury in Multiple Sclerosis (MS). Previous studies assessing predictive value of early sNfL measurements in disability progression were limited in consideration of MRI activity.

Objective Evaluate the association between sNfL and progression in a cohort of persons living with early relapsing remitting Multiple Sclerosis (RRMS), controlling for both clinical and radiological activity.

Design/Methods

This cross-sectional evaluation examined the relationship between (a) disability progression from baseline to year-three and (b) sNfL measured at year 3 within RADIEMS, a prospective longitudinal cohort study that enrolled participants soon after MS diagnosis (<5 years). Disability progression was defined by 3 strata EDSS increases from baseline to three-year follow-up (n=108). After generalized linear modeling adjusted sNfL for age, time since diagnosis, and interim inflammatory activity (relapse or MRI activity), non-parametric tests (using SPSS) evaluated differences in sNfL between patients with and without disability progression.

Results

The cohort was 65.7% female, aged 37.4±7.7 years. EDSS worsened in 29 (26.9%) patients. Serum NfL adjusted for age and time since diagnosis was greater in patients with versus without EDSS worsening: median (IQR), 9.39 pg/ml (7.27-11.71) vs. 6.81 (4.88-9.15), p=.001, Cohen’s D=0.66. Additional adjustment for interim inflammatory activity still showed higher sNFL levels among patients with versus without EDSS worsening: 8.54 pg/ml (6.70-12.32) vs. 6.86 pg/ml (4.43-9.93), p=.013, Cohen’s D=0.49. Magnitude of raw EDSS change from baseline also correlated with higher sNfL levels both adjusted for (r_s=0.278, p=0.004) and unadjusted for (r_s=0.341, p<0.001) interim inflammatory activity.

Conclusions

Serum NfL measurement early in RRMS disease course correlated with worsening EDSS even when controlling for clinical and radiologic activity. This suggests a role for sNfL in identifying patients with disability progression independent of activity in early MS, though further longitudinal study is needed to better assess the predictive value of sNfL over time.

Authors/Disclosures
Sammita Satyanarayan, MD (Mount Sinai Medical Center) PRESENTER	Dr. Satyanarayan has nothing to disclose.
Ilana B. Katz Sand, MD (Corinne Goldsmith Dickinson Center for MS)	The institution of Dr. Katz Sand has received research support from National Multiple Sclerosis Society. The institution of Dr. Katz Sand has received research support from Hirschl Foundation. The institution of Dr. Katz Sand has received research support from National Institutes of Health. Dr. Katz Sand has received personal compensation in the range of $500-$4,999 for serving as a Conference presenter with American Academy of Neurology.
James F. Sumowski (Icahn School of Medicine At Mount Sinai)	Mr. Sumowski has nothing to disclose.