Blood test may predict worsening disability in MS
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A blood test may be able to identify patients with multiple sclerosis who are more likely to have worsening disability, according to research published in Neurology, the medical journal of the American Academy of Neurology.
“In a disease like MS that is so unpredictable and varies so much from one person to the next, having a noninvasive blood test like this could be very valuable, especially since treatments are most effective in the earliest stages of the disease,” Ali Manouchehrinia, PhD, assistant professor in the department of neuroscience at the Karolinska Institutet in Stockholm, Sweden, said in a press release.
Manouchehrinia and colleagues used blood tests to assess concentrations of plasma neurolament light chain (pNfL), which they explained had previously been associated with brain atrophy and long-term outcomes in patients with MS.
The analysis included 4,385 participants with MS and 1,026 sex- and age-matched controls from two large prospective cohorts in Sweden. MS disability was measured with the Expanded Disability Status Scale (EDSS) during routine clinical visits annually or biannually. Participants were followed up for a median of 5 years.
The median pNfL of controls was 7.5 pg/mL vs. 11.4pg/mL in those with MS, according to the researchers. Compared with those with low pNfL levels, participants with high pNfL levels were 40% to 70% more likely to have a worsening EDSS score in the next year.
The researchers also found that patients with MS who had high pNfL levels were approximately 50% more likely to reach a sustained EDSS score indicating moderate disability or significant disability, but still able to walk without resting for 500 m.
However, there was no consistent association between high pNfL levels and an increased risk for an EDSS score indicating more severe disability where assistance is needed to walk 100 m without resting or with an increased risk for secondary progressive MS, the researchers reported.
“These results suggest that elevated levels of these proteins measured early on in the course of the disease may help us to predict how the disease will develop and monitor how treatment is working,” Manouchehrinia said in the press release. “More research is needed before a blood test could be used routinely in the clinical setting, but our results are encouraging.” – by Erin Michael
Disclosures: Manouchehrinia reports receiving financial support from the Margaretha af Ugglas Foundation. Please see the study for all other authors’ relevant financial disclosures.