BACKGROUND:
In order to accelerate the development of new treatments able to stop disease worsening for progressive forms of multiple sclerosis (MS), there is a need to identify a biological marker that can effectively and accurately measure progression. A biological marker is a material naturally found in the body that is the product of a disease. Its levels can be measured and are indicative or predictive of disease and can be used to help determine the effect of treatment.
OVERVIEW:
The International Progressive MS Alliance (also known as “the Alliance”) convened an expert panel, including people affected by MS, researchers, and clinicians to focus on biomarkers for progressive MS. In the September, 8, 2020 issue of Neurology, the panel published their first paper summarizing the state of knowledge and highlighted evidence for one of the most promising biomarkers called ‘neurofilament light (NfL)’, an important component of nerve cells that is released into the blood stream following damage or as a result of neurodegeneration.
Recent clinical trials in MS have demonstrated that NfL levels as a possible indicator of treatment effect in both relapsing and progressive forms of MS. NfL levels are able to predict relapse rates, brain tissue loss, disability progression and can be used as indicators of treatment response. NfL is also detected in healthy individuals, and its concentrations can increase with age.
In the publication, the expert panel outlined recommendations for additional research needed to overcome the current challenges in using NfL as a biomarker, such as the development of standardized procedures for sample collection and analysis, understanding the differences in NfL levels for active inflammation versus disease progression, and the effect of age and comorbid conditions (e.g. effect on NfL levels from other neurological diseases such as Alzheimer’s disease). Additionally, the Alliance is seeking to have drug regulators recognize NfL as a measure of treatment response so that it can be used as a biomarker in clinical trials for new therapies.
IMPACT:
This publication and the ongoing work from the Alliance will help advance the goal of accelerating new treatments for people with progressive MS.
Publication:
“Serum Neurofilament Light as a Biomarker in Progressive Multiple Sclerosis” was published online in Neurology on July 16, 2020, by authors Raju Kapoor, FRCP (University College London), Robert J Fox, MD (Mellen Center for Multiple Sclerosis, Cleveland Clinic), and their international collaborators. Anyone can read the paper without a subscription.
Listen to a RealTalkMS podcast interview with some of the authors