Setting the scene: the relevance of conventional CSF and imaging biomarkers in MS
ECTRIMS Online Library. Piehl F. 09/11/19; 279401; 67
Fredrik Piehl
Fredrik Piehl
Contributions
Abstract

Abstract: 67

Type: Educational Session

Abstract Category: Educational Session 9: Neurofilament light chains and other fluid bi

F. Piehl

Clinical Neuroscience, Karolinska Insitutet, Solna, Sweden

Multiple sclerosis (MS) is characterized by focal white matter inflammation in the brain and spinal cord. Such lesions can be visualized with magnetic resonance imaging (MRI), the only established biomarker of disease activity in clinical routine today. However, it is evident that also grey and normal appearing white matter are affected in MS; pathology for which standard MRI techniques are less sensitive. Similarly, although different brain volumetric measurements show strong correlation to development of disability at the group level, they are relatively insensitive to individual changes, at least over shorter time periods. In this context fluid biomarkers could provide important additional information to assess active disease processes such as neuro-axonal degeneration, arguably the most important determinant for long term disability. There is now a robust body of evidence suggesting that neurofilament light (NfL) could serve this purpose. Hence, early studies in MS have demonstrated significant correlations between the cerebrospinal fluid (CSF) NfL concentration and degree of disability and relapse rates. Initial findings now have been replicated and extended to include also effects by disease modulatory treatments (DMT), suggesting that NfL can be used to monitor therapeutic efficacy. In this presentation the clinical applications of NfL measurements will be discussed, also in the context of other biomarkers of disease activity, as well as the experiences in the Nordic countries of CSF NfL measurements in clinical routine.
Disclosure: FP has received research grants from Genzyme, Merck KGaA and Novartis, and fees for serving as Chair of DMC in clinical trials with Parexel.

Abstract: 67

Type: Educational Session

Abstract Category: Educational Session 9: Neurofilament light chains and other fluid bi

F. Piehl

Clinical Neuroscience, Karolinska Insitutet, Solna, Sweden

Multiple sclerosis (MS) is characterized by focal white matter inflammation in the brain and spinal cord. Such lesions can be visualized with magnetic resonance imaging (MRI), the only established biomarker of disease activity in clinical routine today. However, it is evident that also grey and normal appearing white matter are affected in MS; pathology for which standard MRI techniques are less sensitive. Similarly, although different brain volumetric measurements show strong correlation to development of disability at the group level, they are relatively insensitive to individual changes, at least over shorter time periods. In this context fluid biomarkers could provide important additional information to assess active disease processes such as neuro-axonal degeneration, arguably the most important determinant for long term disability. There is now a robust body of evidence suggesting that neurofilament light (NfL) could serve this purpose. Hence, early studies in MS have demonstrated significant correlations between the cerebrospinal fluid (CSF) NfL concentration and degree of disability and relapse rates. Initial findings now have been replicated and extended to include also effects by disease modulatory treatments (DMT), suggesting that NfL can be used to monitor therapeutic efficacy. In this presentation the clinical applications of NfL measurements will be discussed, also in the context of other biomarkers of disease activity, as well as the experiences in the Nordic countries of CSF NfL measurements in clinical routine.
Disclosure: FP has received research grants from Genzyme, Merck KGaA and Novartis, and fees for serving as Chair of DMC in clinical trials with Parexel.

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