Serum Neurofilament Levels in Newly Presenting Patients with Multiple Sclerosis and Disease Worsening

Serum neurofilament (sNfL) has been shown to be associated with multiple sclerosis (MS) disease activity and worsening (NEJM JW Neurol Apr 20 2022 and Lancet Neurol 2022; 21:246), but associations with longer-term outcomes have been unclear. Investigators studied sNfL in two retrospective cohorts of patients presenting with a first demyelinating event suggestive of MS: 327 patients in a development cohort and 251 in a validation cohort. Median follow-up was 7 years.

Elevated sNfL, defined as >10 pg/mL or z-score >1.5, was present at baseline in approximately 45% of patients. In the validation cohort those with elevated sNfL had a hazard ratio (HR) of 1.6 for 6-month confirmed disability worsening and a HR of 2.0 for reaching an Expanded Disa…