Multiple sclerosis (Houndmills, Basingstoke, England) · 2026
Neurofilament light chain as a surrogate candidate for disease activity in multiple sclerosis (LUMINOUS)-A meta-regression of randomized controlled trials.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод в очереди
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Pretzsch Roxanne, El Mahdaoui Sahla, Johnson Poljanka, Soares Mafalda Delgado, Koerbel Kimberly, Held Friederike, Bajrami Albulena, Pozzilli Valeria, Lucchini Matteo, Barbuti Elena, Bartels Frederik, Barket Robert, Cordano Christian, Hemmer Bernhard, Cagol Alessandro, Schiavetti Irene, Sormani Maria Pia, ECTRIMS Winter School 2024 study group
Аннотация
BACKGROUND/OBJECTIVES: Neurofilament light chain (NfL) is a promising biomarker for monitoring disease activity and treatment response in multiple sclerosis (MS). This meta-regression assesses the relationship between treatment effects on serum/plasma NfL (s/pNfL) and clinical and radiological endpoints in randomized controlled trials (RCTs).
METHODS: A systematic PubMed search identified RCTs in MS (1999-2023) with ⩾24 months' duration and s/pNfL data. Extracted outcomes included treatment effects on s/pNfL, annualized relapse rate (ARR), confirmed disability worsening (CDW), magnetic resonance imaging (MRI) new/enlarging T2 lesions, and percentage brain volume change (PBVC). We evaluated the association of treatment effect on the selected outcomes at the trial level by a meta-regression, weighted by trial size and duration.
RESULTS: Fifteen RCTs (n = 6814) were included, nine in relapsing MS (RMS, n = 5221), and six in progressive MS (PMS, n = 1593). Treatment effects on s/pNfL showed a moderate association with treatment effects on MRI new/enlarging T2 lesions (R2 = 0.42, p = 0.01), ARR (R2= 0.33, p = 0.03) and CDW (R2= 0.30, p = 0.04), but not with PBVC. In RMS-only trials, association with ARR (R2= 0.45, p = 0.05) and CDW (R2= 0.50, p = 0.03) was more pronounced.
CONCLUSION: In MS, treatment effects on s/pNfL are moderately associated with therapeutic effects on ARR, MRI new/enlarging T2 lesions, and CDW, whereas no consistent association was observed with PBVC.
METHODS: A systematic PubMed search identified RCTs in MS (1999-2023) with ⩾24 months' duration and s/pNfL data. Extracted outcomes included treatment effects on s/pNfL, annualized relapse rate (ARR), confirmed disability worsening (CDW), magnetic resonance imaging (MRI) new/enlarging T2 lesions, and percentage brain volume change (PBVC). We evaluated the association of treatment effect on the selected outcomes at the trial level by a meta-regression, weighted by trial size and duration.
RESULTS: Fifteen RCTs (n = 6814) were included, nine in relapsing MS (RMS, n = 5221), and six in progressive MS (PMS, n = 1593). Treatment effects on s/pNfL showed a moderate association with treatment effects on MRI new/enlarging T2 lesions (R2 = 0.42, p = 0.01), ARR (R2= 0.33, p = 0.03) and CDW (R2= 0.30, p = 0.04), but not with PBVC. In RMS-only trials, association with ARR (R2= 0.45, p = 0.05) and CDW (R2= 0.50, p = 0.03) was more pronounced.
CONCLUSION: In MS, treatment effects on s/pNfL are moderately associated with therapeutic effects on ARR, MRI new/enlarging T2 lesions, and CDW, whereas no consistent association was observed with PBVC.