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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00007686naa a2200913 4500
001oai:gup.ub.gu.se/314267
003SwePub
008240528s2022 | |||||||||||000 ||eng|
009oai:prod.swepub.kib.ki.se:148965345
024a https://gup.ub.gu.se/publication/3142672 URI
024a https://doi.org/10.1016/S1474-4422(22)00009-62 DOI
024a http://kipublications.ki.se/Default.aspx?queryparsed=id:1489653452 URI
040 a (SwePub)gud (SwePub)ki
041 a eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
100a Benkert, P.4 aut
2451 0a Serum neurofilament light chain for individual prognostication of disease activity in people with multiple sclerosis: a retrospective modelling and validation study
264 1c 2022
520 a Background: Serum neurofilament light chain (sNfL) is a biomarker of neuronal damage that is used not only to monitor disease activity and response to drugs and to prognosticate disease course in people with multiple sclerosis on the group level. The absence of representative reference values to correct for physiological age-dependent increases in sNfL has limited the diagnostic use of this biomarker at an individual level. We aimed to assess the applicability of sNfL for identification of people at risk for future disease activity by establishing a reference database to derive reference values corrected for age and body-mass index (BMI). Furthermore, we used the reference database to test the suitability of sNfL as an endpoint for group-level comparison of effectiveness across disease-modifying therapies. Methods: For derivation of a reference database of sNfL values, a control group was created, comprising participants with no evidence of CNS disease taking part in four cohort studies in Europe and North America. We modelled the distribution of sNfL concentrations in function of physiological age-related increase and BMI-dependent modulation, to derive percentile and Z score values from this reference database, via a generalised additive model for location, scale, and shape. We tested the reference database in participants with multiple sclerosis in the Swiss Multiple Sclerosis Cohort (SMSC). We compared the association of sNfL Z scores with clinical and MRI characteristics recorded longitudinally to ascertain their respective disease prognostic capacity. We validated these findings in an independent sample of individuals with multiple sclerosis who were followed up in the Swedish Multiple Sclerosis registry. Findings: We obtained 10 133 blood samples from 5390 people (median samples per patient 1 [IQR 1–2] in the control group). In the control group, sNfL concentrations rose exponentially with age and at a steeper increased rate after approximately 50 years of age. We obtained 7769 samples from 1313 people (median samples per person 6·0 [IQR 3·0–8·0]). In people with multiple sclerosis from the SMSC, sNfL percentiles and Z scores indicated a gradually increased risk for future acute (eg, relapse and lesion formation) and chronic (disability worsening) disease activity. A sNfL Z score above 1·5 was associated with an increased risk of future clinical or MRI disease activity in all people with multiple sclerosis (odds ratio 3·15, 95% CI 2·35–4·23; p<0·0001) and in people considered stable with no evidence of disease activity (2·66, 1·08–6·55; p=0·034). Increased Z scores outperformed absolute raw sNfL cutoff values for diagnostic accuracy. At the group level, the longitudinal course of sNfL Z score values in people with multiple sclerosis from the SMSC decreased to those seen in the control group with use of monoclonal antibodies (ie, alemtuzumab, natalizumab, ocrelizumab, and rituximab) and, to a lesser extent, oral therapies (ie, dimethyl fumarate, fingolimod, siponimod, and teriflunomide). However, longitudinal sNfL Z scores remained elevated with platform compounds (interferons and glatiramer acetate; p<0·0001 for the interaction term between treatment category and treatment duration). Results were fully supported in the validation cohort (n=4341) from the Swedish Multiple Sclerosis registry. Interpretation: The use of sNfL percentiles and Z scores allows for identification of individual people with multiple sclerosis at risk for a detrimental disease course and suboptimal therapy response beyond clinical and MRI measures, specifically in people with disease activity-free status. Additionally, sNfL might be used as an endpoint for comparing effectiveness across drug classes in pragmatic trials. Funding: Swiss National Science Foundation, Progressive Multiple Sclerosis Alliance, Biogen, Celgene, Novartis, Roche. © 2022 Elsevier Ltd
650 7a MEDICIN OCH HÄLSOVETENSKAPx Medicinska och farmaceutiska grundvetenskaperx Neurovetenskaper0 (SwePub)301052 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Basic Medicinex Neurosciences0 (SwePub)301052 hsv//eng
700a Meier, S.4 aut
700a Schaedelin, S.4 aut
700a Manouchehrinia, A.u Karolinska Institutet4 aut
700a Yaldizli, Ö4 aut
700a Maceski, A.4 aut
700a Oechtering, J.4 aut
700a Achtnichts, L.4 aut
700a Conen, D.4 aut
700a Derfuss, T.4 aut
700a Lalive, P. H.4 aut
700a Mueller, C.4 aut
700a Müller, S.4 aut
700a Naegelin, Y.4 aut
700a Oksenberg, J. R.4 aut
700a Pot, C.4 aut
700a Salmen, A.4 aut
700a Willemse, E.4 aut
700a Kockum, I.u Karolinska Institutet4 aut
700a Blennow, Kaj,d 1958u Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry4 aut0 (Swepub:gu)xbleka
700a Zetterberg, Henrik,d 1973u Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry4 aut0 (Swepub:gu)xzethe
700a Gobbi, C.4 aut
700a Kappos, L.4 aut
700a Wiendl, H.4 aut
700a Berger, K.4 aut
700a Sormani, M. P.4 aut
700a Granziera, C.4 aut
700a Piehl, F.u Karolinska Institutet4 aut
700a Leppert, D.4 aut
700a Kuhle, J.4 aut
700a Aeschbacher, S.4 aut
700a Barakovic, M.4 aut
700a Buser, A.4 aut
700a Chan, A.4 aut
700a Disanto, G.4 aut
700a D'Souza, M.4 aut
700a Du Pasquier, R.4 aut
700a Findling, O.4 aut
700a Galbusera, R.4 aut
700a Hrusovsky, K.4 aut
700a Khalil, M.4 aut
700a Lorscheider, J.4 aut
700a Mathias, A.4 aut
700a Orleth, A.4 aut
700a Radue, E. W.4 aut
700a Rahmanzadeh, R.4 aut
700a Sinnecker, T.4 aut
700a Subramaniam, S.4 aut
700a Vehoff, J.4 aut
700a Wellmann, S.4 aut
700a Wuerfel, J.4 aut
700a Zecca, C.4 aut
710a Karolinska Institutetb Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi4 org
773t The Lancet Neurologyg 21:3, s. 246-257q 21:3<246-257x 1474-4422x 1474-4465
8564 8u https://gup.ub.gu.se/publication/314267
8564 8u https://doi.org/10.1016/S1474-4422(22)00009-6
8564 8u http://kipublications.ki.se/Default.aspx?queryparsed=id:148965345

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