Abstract Details

Title Real Life Evidence for CSF Neurofilaments Light Chain in Clinical Practice.

Topic Multiple Sclerosis

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-021

Objective

To describe the treatment decision-making based on cerebrospinal fluid (CSF) neurofilament light chain (NfL) levels in people with multiple sclerosis (pwMS) at the BartsMS Centre, London, UK.

Background

In recent studies, the level of NfL has shown utility to predict disease activity and progression of disability in pwMS. However, the influence of NfL levels on treatment decision in pwMS remains unknown. The BartsMS Centre has been offering CSF NfL for clinical decision making since December 2015.

Design/Methods A cohort analysis was conducted among patients with clinically definite MS attending the BartsMS Centre, who would have had CSF NfL's levels measured between December 2015 to December 2017. Descriptive analysis is planned to show the influence of NfL levels for treatment decision-making, whether to start, escalate or continue with the same treatment.

Results A total of 107 pwMS and NfL's tests were included. Mean (±SD) age was 41.11±12.6 years. 68 (63.6%) were female and 58 (54.2%) had relapsing-remitting MS. Median EDSS was 3 (IQR 1-5). 51 pwMS had high NfL (48%), of which 34 (67%) either started highly-active or escalated treatment, while 17 (33%) either went on first-line, no treatment, or no treatment and the clinician was unaware of the result. Of 56 (52%) normal test results, 16 (29%) either started highly-active or escalated treatment, while 40 (71%) went on first-line, not escalated, no treatment, or no treatment and the clinician was unaware of the result. Detailed analysis will be presented at the meeting.

Conclusions

The NfL level has shown association with relapse, radiological activity and progression of disability in pwMS. We have found from our centre that whether the NfL test is elevated or not influences decision making in the selection of DMTs, this decision is often taken together with clinical as well as MRI findings.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
David Holden	No disclosure on file
	No disclosure on file
Francesca Ammoscato	No disclosure on file
Benjamin Turner, MD, MBBS (Barts and The Royal London Hospitals)	No disclosure on file
Klaus Schmierer, MD, PhD (The Blizard Institute, Centre for Neuroscience, Surgery & Trauma)	Dr. Schmierer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AXDEV. Dr. Schmierer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for MedScape. Dr. Schmierer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NeuroDiem. Dr. Schmierer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurology Academy. Dr. Schmierer has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck KGaA. Dr. Schmierer has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Merck KGaA. Dr. Schmierer has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for F. Hoffmann-La Roche AG. Dr. Schmierer has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Novartis. Dr. Schmierer has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Teva.
	No disclosure on file
Gavin Giovannoni, MD (QMUL)	Dr. Giovannoni has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck KGaA. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche-Genentech. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Moderna. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sandoz. Dr. Giovannoni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Astoria Biologica. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Zenas. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Giovannoni has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Giovannoni has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Medscape.
	No disclosure on file

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