Multiple sclerosis (Houndmills, Basingstoke, England) · 2026
Serum neurofilament light chain in paediatric patients treated with natalizumab for highly active multiple sclerosis.
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Huppke Brenda, Reinert Marie-Christine, Stark Wiebke, Gärtner Jutta, Huppke Peter
Аннотация
BACKGROUND: Natalizumab (NTZ) effectively suppresses clinical and radiologic disease activity in paediatric patients with multiple sclerosis (MS), however, it is unclear whether serum neurofilament light chain (sNfL), a biomarker of neuronal injury, normalizes.
OBJECTIVE: To evaluate sNfL response to NTZ in the paediatric setting.
METHODS: sNfL was measured (single-molecule array) in 66 paediatric patients on NTZ for highly active MS in a single-centre between 2007 and 2023. sNfL levels were converted to age-adjusted z-scores for longitudinal assessment.
RESULTS: sNfL declined significantly on NTZ, however, not all patients achieved normalized levels. Percentage of patients with sNfL < 90th percentile of healthy aged-matched individuals increased from 6.8% initially to 50%, 65% and 75% within 12, 24 and 36 treatment-months, respectively. Higher on-treatment levels were associated with higher baseline levels (B = 0.791, p < 0.001) and John Cunningham virus (JCV) seropositivity (B = 0.286, p < 0.001). sNfL > 97th percentile at 12 treatment-months indicated greater likelihood of disease activity in following year.
CONCLUSIONS: NTZ treatment resulted in a significant reduction in sNfL levels, correlating with its clinical efficacy in paediatric MS. However, higher baseline sNfL concentrations were associated with a prolonged time to normalization. In addition, JCV seropositivity was linked to elevated NfL levels during treatment.
OBJECTIVE: To evaluate sNfL response to NTZ in the paediatric setting.
METHODS: sNfL was measured (single-molecule array) in 66 paediatric patients on NTZ for highly active MS in a single-centre between 2007 and 2023. sNfL levels were converted to age-adjusted z-scores for longitudinal assessment.
RESULTS: sNfL declined significantly on NTZ, however, not all patients achieved normalized levels. Percentage of patients with sNfL < 90th percentile of healthy aged-matched individuals increased from 6.8% initially to 50%, 65% and 75% within 12, 24 and 36 treatment-months, respectively. Higher on-treatment levels were associated with higher baseline levels (B = 0.791, p < 0.001) and John Cunningham virus (JCV) seropositivity (B = 0.286, p < 0.001). sNfL > 97th percentile at 12 treatment-months indicated greater likelihood of disease activity in following year.
CONCLUSIONS: NTZ treatment resulted in a significant reduction in sNfL levels, correlating with its clinical efficacy in paediatric MS. However, higher baseline sNfL concentrations were associated with a prolonged time to normalization. In addition, JCV seropositivity was linked to elevated NfL levels during treatment.