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Plasma NfL Level Tied to Risk for Disability in Multiple Sclerosis

High pNfL levels linked to increased adjusted rates of Expanded Disability Status Scale worsening


WEDNESDAY, May 20, 2020 (HealthDay News) -- Elevated plasma neurofilament light chain (pNfL) levels are associated with an increased risk for reaching sustained disability worsening in multiple sclerosis (MS), according to a study published online May 20 in Neurology.

Ali Manouchehrinia, Ph.D., from the Karolinska Institutet in Stockholm, and colleagues determined concentrations of pNfL in 4,385 persons with MS and 1,026 age- and sex-matched controls; patients were followed for a median of five years. The impact of age-stratified pNfL levels above the 80th, 95th, and 99th percentiles among controls and risk for Expanded Disability Status Scale (EDSS) worsening were assessed.

The researchers found a median pNfL of 7.5 and 11.4 pg/mL in controls and individuals with MS, respectively. High pNfL was associated with increased adjusted rates of EDSS worsening within the following year, ranging from 1.4 to 1.7. High pNfL was also associated with the risk for reaching a sustained EDSS score of 3.0; over all percentile cutoffs, the adjusted rates ranged from 1.5 to 1.55. For the risk for a sustained EDSS score of 4.0, similar increases were seen. The investigators observed no consistently significant risk for reaching an EDSS score of 6.0 or conversion to secondary progressive multiple sclerosis.

"pNfL may serve as a prognostic and treatment monitoring tool to assess the risk of developing permanent disability in MS as part of a more standardized, noninvasive, longitudinally accessible, and generalizable approach," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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