TY - JOUR
T1 - Serum glial fibrillary acidic protein in natalizumab-treated relapsing-remitting multiple sclerosis
T2 - An alternative to neurofilament light
AU - Wessels, Mark H. J.
AU - van Lierop, Zoë Y. GJ
AU - Noteboom, Samantha
AU - Strijbis, Eva M. M.
AU - Heijst, Johannes A.
AU - van Kempen, Zoé L. E.
AU - Moraal, Bastiaan
AU - Barkhof, Frederik
AU - Uitdehaag, Bernard M. J.
AU - Schoonheim, Menno M.
AU - Killestein, Joep
AU - Teunissen, Charlotte E.
N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The MS Center Amsterdam was supported by a program grant from the Dutch MS Research Foundation (18-358f) and the 3TR grant (grant agreement No 831434). Frederik Barkhof is supported by the NIHR biomedical research center at University College London Hospital. Publisher Copyright: © The Author(s), 2023.
PY - 2023/9
Y1 - 2023/9
N2 - Background: There is a need in Relapsing-Remitting Multiple Sclerosis (RRMS) treatment for biomarkers that monitor neuroinflammation, neurodegeneration, treatment response, and disease progression despite treatment. Objective: To assess the value of serum glial fibrillary acidic protein (sGFAP) as a biomarker for clinical disease progression and brain volume measurements in natalizumab-treated RRMS patients. Methods: sGFAP and neurofilament light (sNfL) were measured in an observational cohort of natalizumab-treated RRMS patients at baseline, +3, +12, and +24 months and at the last sample follow-up (median 5.17 years). sGFAP was compared between significant clinical progressors and non-progressors and related to magnetic resonance imaging (MRI)-derived volumes of the whole brain, ventricle, thalamus, and lesion. The relationship between sGFAP and sNfL was assessed. Results: A total of 88 patients were included, and 47.7% progressed. sGFAP levels at baseline were higher in patients with gadolinium enhancement (1.3-fold difference, p = 0.04) and decreased in 3 months of treatment (adj. p < 0.001). No association was found between longitudinal sGFAP levels and progressor status. sGFAP at baseline and 12 months was significantly associated with normalized ventricular (positively), thalamic (negatively), and lesion volumes (positively). Baseline and 12-month sGFAP predicted annualized ventricle volume change rate after 1 year of treatment. sGFAP correlated with sNfL at baseline (p < 0.001) and last sample follow-up (p < 0.001) but stabilized earlier. Discussion: sGFAP levels related to MRI markers of neuroinflammation and neurodegeneration.
AB - Background: There is a need in Relapsing-Remitting Multiple Sclerosis (RRMS) treatment for biomarkers that monitor neuroinflammation, neurodegeneration, treatment response, and disease progression despite treatment. Objective: To assess the value of serum glial fibrillary acidic protein (sGFAP) as a biomarker for clinical disease progression and brain volume measurements in natalizumab-treated RRMS patients. Methods: sGFAP and neurofilament light (sNfL) were measured in an observational cohort of natalizumab-treated RRMS patients at baseline, +3, +12, and +24 months and at the last sample follow-up (median 5.17 years). sGFAP was compared between significant clinical progressors and non-progressors and related to magnetic resonance imaging (MRI)-derived volumes of the whole brain, ventricle, thalamus, and lesion. The relationship between sGFAP and sNfL was assessed. Results: A total of 88 patients were included, and 47.7% progressed. sGFAP levels at baseline were higher in patients with gadolinium enhancement (1.3-fold difference, p = 0.04) and decreased in 3 months of treatment (adj. p < 0.001). No association was found between longitudinal sGFAP levels and progressor status. sGFAP at baseline and 12 months was significantly associated with normalized ventricular (positively), thalamic (negatively), and lesion volumes (positively). Baseline and 12-month sGFAP predicted annualized ventricle volume change rate after 1 year of treatment. sGFAP correlated with sNfL at baseline (p < 0.001) and last sample follow-up (p < 0.001) but stabilized earlier. Discussion: sGFAP levels related to MRI markers of neuroinflammation and neurodegeneration.
KW - MRI volumetrics
KW - Multiple scleroris
KW - disability-progression
KW - glial-fibrillary-acidic-protein
KW - natalizumab
KW - neurofilament light
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85166984908&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/37530045
U2 - https://doi.org/10.1177/13524585231188625
DO - https://doi.org/10.1177/13524585231188625
M3 - Article
C2 - 37530045
SN - 1352-4585
VL - 29
SP - 1229
EP - 1239
JO - MULTIPLE SCLEROSIS JOURNAL
JF - MULTIPLE SCLEROSIS JOURNAL
IS - 10
ER -