Barrero Hernández Francisco J, Romero Villarrubia Ana, Muñoz Fernández Carmen, Guillén Martinez Virginia, Aguilera Del Moral Almudena, Barrios-López José María, Ramírez Rivas Maria A, Gálvez Muñoz Antonio J, Piñar Morales Raquel
Neurology Unit, University Hospital Clinic San Cecilio, 18016 Granada, Spain.
Instituto de Investigación Biosanitaria ibs.Granada, 18012 Granada, Spain.
J Pers Med. 2024 Jun 27;14(7):692. doi: 10.3390/jpm14070692.
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.
血清神经丝轻链（sNfL）水平已被提议作为多发性硬化症患者（PwMS）临床活动、残疾进展及治疗反应的生物标志物；然而，其在临床实践中的应用仍存在疑问。奥瑞珠单抗（OCR）已被证明在改善临床和影像学结果以及降低sNfL水平方面有效。这项真实世界研究跟踪了30例接受OCR治疗12个月的PwMS患者的sNfL水平，并考虑扩展残疾状态量表（EDSS）、年化复发率（ARR）、影像学活动和无疾病活动证据-3（NEDA-3）值，评估了该生物标志物对其短期预后的有用性。OCR使83%的PwMS患者的ARR降低，80%的患者影像学活动减少。EDSS得以维持，而在12个月时70%的患者达到了NEDA-3状态。OCR使sNfL水平早期降低（3个月时）。在基线时，MRI评估的更高影像学活动与更高的sNfL水平相关。治疗前12个月的sNfL水平并未预测疾病的次优反应或持续控制情况。需要进行长期研究以探索sNfL水平在接受高效药物治疗的PwMS患者中的预测有用性。
