Effect of alemtuzumab over sNfL and sGFAP levels in multiple sclerosis

• Published in: Frontiers in immunology Vol. 15; p. 1454474
• Main Authors: Sainz-Amo, Raquel, Rodero Romero, Alexander, Monreal, Enric, Chico García, Juan Luis, Fernández Velasco, José Ignacio, Villarrubia, Noelia, Veiga González, Jose Luis, Sainz de la Maza, Susana, Rodríguez Jorge, Fernando, Masjuan, Jaime, Costa-Frossard, Lucienne, Villar, Luisa María
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 19.08.2024
• Subjects: Adult; alemtuzumab; Alemtuzumab - therapeutic use; Biomarkers - blood; Female; Glial Fibrillary Acidic Protein - blood; Humans; Immunologic Factors - therapeutic use; Immunology; Male; multiple sclerosis; Multiple Sclerosis - blood; Multiple Sclerosis - drug therapy; Multiple Sclerosis, Relapsing-Remitting - blood; Multiple Sclerosis, Relapsing-Remitting - drug therapy; Multiple Sclerosis, Relapsing-Remitting - immunology; Neurofilament Proteins - blood; Prospective Studies; sGFAP; SiMoA; sNfL; Treatment Outcome; SiMoA; alemtuzumab; sGFAP; sNfL; multiple sclerosis
• ISSN: 1664-3224; 1664-3224
• DOI: 10.3389/fimmu.2024.1454474

Alemtuzumab is a highly effective pulsed immune reconstitution therapy for multiple sclerosis (MS). To evaluate serum neurofilament light chain (sNfL) and serum glial fibrillary acidic protein (sGFAP) in patients with relapsing-remitting MS who have been treated with Alemtuzumab over the course of 2 years. This prospective study involved MS patients treated with Alemtuzumab at a referral MS center. Both sNfL and sGFAP were analyzed at baseline and then again at 6, 12, and 24 months post-treatment using the single molecule array (SiMoA) technique. We also recruited matched healthy controls (HCs) for comparison. The study included 46 patients (with a median age of 34.2 [Interquartile range (IQR), 28.7-42.3] years, 27 of which were women [58%]) and 76 HCs. No differences in demographic characteristics were observed between patients and HC. The median disease duration was 6.22 (IQR, 1.56-10.13) years. The median annualized relapse rate before treatment was 2 (IQR, 1-3). At baseline, sNfL and sGFAP levels were higher in MS patients (median of 18.8 [IQR, 10.7-52.7] pg/ml and 158.9 [IQR, 126.9-255.5] pg/ml, respectively) when compared to HC (6.11 [IQR, 2.03-8.54] pg/ml and 91.0 [72.6-109] pg/ml, respectively) (p<0.001 for both comparisons). The data indicates that 80% of patients had high (≥10 pg/ml) sNfL values at baseline. We observed a significant decrease in sNfL levels at 6 (65%, p = 0.02), 12 (70.8%, p<0.001), and 24 (78.1%, p<0.001) months. sNfL reached similar levels to HC only after 24 months of Alemtuzumab treatment. During the follow-up period, no changes were identified in the sGFAP values. Alemtuzumab leads to the normalization of sNfL values in MS patients after 2 years of treatment, with no apparent effect on sGFAP values.