This study aimed to assess the acceptance of serum neurofilament light chain (sNfL) testing among patients with early-stage relapsing-remitting MS (RRMS) and to identify associated factors.

sNfL testing correlates with multiple sclerosis disease activity, indicating its potential as a prognostic and treatment monitoring tool. However, initial patient awareness of sNfL and its potential benefits is limited.

A non-interventional, cross-sectional study was conducted across 16 neuroimmunology hospital-based clinics. We included RRMS patients with a disease duration of ≤3 years who were on disease-modifying therapy. Patient acceptance of sNfL testing was evaluated after providing them with a brief tutorial describing its benefits. Multivariate logistic regression was used to identify predictors of acceptance.

The study included 147 patients (mean age 37.0 [SD 10.3] years, 69.4% female). Median disease duration was 1.3 years (IQR 0.8-2.1), and median EDSS score was 1.5 (IQR 0.0-2.0). A total of 84.0% of patients (N=121) agreed/strongly agreed to accept sNfL testing after being informed about its benefits. Furthermore, 62.5% (N=90) reported that they would feel more at ease while awaiting an MRI/follow-up visit if they knew sNfL levels were below their z-score. Before receiving this information, only 40.3% of patients (N=58) were aware of sNfL. Patients willing to undergo sNfL testing demonstrated higher knowledge of disease, reported greater treatment decision regret, and showed better physical quality of life and Symbol Digit Modalities Test performance compared to their counterparts. Higher disease knowledge (OR=1.52, 95%CI 1.16-1.99; p=0.002) and less severe symptom endorsement (OR=0.96, 95%CI 0.93-0.99; p=0.038) were associated with greater acceptance of sNfL testing in the multivariate analysis.

Patients, when informed about the benefits of sNfL testing, showed a high willingness to accept it. Disease knowledge predicted acceptance. These findings support the integration of sNfL into personalized MS management, especially with effective patient education.