NeofiLos is a project assessing the clinical utility of serial sNfL testing among office based neurologists in Germany.

Neuroaxonal damage results in release of neurofilaments such as neurofilament light chain (NfL) with elevated NfL potentially indicating RMS disease activity^[1][2][3].

Elevated NfL levels may reveal "subclinical" disease before lesions or clinical symptoms appear^[4]. Measuring sNfL may help elucidate subclinical disease activity with prognostic value for future disease activity and potentially contribute to optimized decision making.

NeofiLos is an ongoing data collection at 83 office-based neurologists assessing utility of sNfL from physician’s perspective in RMS patients treated with ofatumumab or other approved disease modifying therapies (DMTs). sNfL measured at baseline followed by quarterly interval up to 5x per patient. Values embedded into scientific context using patient demographics are reported to neurologists evaluating perception and implementation of sNfL into clinical routine.

Analysis of 1012 aggregated sNfL values and respective questionnaires at timepoint of program inclusion (TPI) revealed that sNfL levels were elevated in more than 50% of patients where neurologists observed a context of sNfL value with clinical activity.  The majority (73.8%, N=728) of measured sNfL values were not in context with an observed clinical activity, although elevated sNfL values could be detected in 15.1% of this group. Moreover, at presentation data will depict aggregated sNfL values for multiple timepoints after program inclusion, based on therapy (ofatumumab or other DMT) and duration of chosen therapy.

This pilot project for sNfL in routine medical care setting is highlighting importance and benefit of sNfL as additional tool in MS patient management defining actual gaps and optimizing future patient care.