Blood Test Might Predict Worsening of MS

KEY TAKEAWAYS:

The progression of multiple sclerosis is particularly difficult to predict, varying widely between patients
A new blood test uses a biomarker of nerve cell damage to accurately predict progression over the next two years
If the test proves valid, it might help patients and their doctor plan optimal treatments, the researchers said

One issue hampering the care of people with multiple sclerosis is assessing just how quickly the neurological illness might progress.

Now, a team at the University of California, San Francisco (UCSF), say they’ve spotted at test that could help do just that.

Blood tests showing elevated levels of Nfl, a “biomarker” indicating nerve damage, seemed to predict with high accuracy a worsening of MS symptoms over the next two years, the researchers found.

That could help patients and their physicians with treatment planning, said a team led by Dr. Ahmed Abdelhak, of the UCSF Department of Neurology and the Weill Institute for Neurosciences.

“This rising of NfL up to two years before signs of disability worsening represents the window when interventions may prevent worsening,” Abdelhak explained in a UCSF news release.

An MS patient’s level of disability is typically measured by what’s known as the Expanded Disability Status Scale. In the study, Abdelhak’s group used the scale to track how quickly symptoms progressed among individuals in a cohort of almost 1,900 patients with MS. Patients were tracked for about 10 years.

The findings highlighted the unpredictability of MS progression. Among the cohort, 570 patients showed a steady worsening of symptoms, while the disease remained relatively stable over the 10-year period.

Blood tests targeting Nfl seemed to predict whose disease would or wouldn’t progress.

“Elevated NfL levels were associated with up to a 91% higher risk of worsening disability, with relapse approximately a year later, and up to a 49% higher risk of worsening disability without relapse nearly two years later,” the researchers said.

The study was published Nov. 6 in the journal JAMA Neurology.

The study “aligns with recognition that death of nerve cells is a slow process that builds toward permanent disability and means that interventions to protect nerve cells might have time to also stop disability,” said study co-senior author Dr. Ari Green, medical director of the UCSF Multiple Sclerosis and Neuroinflammation Center.

More information

Find out more about multiple sclerosis at the National MS Society.

SOURCE: UCSF news release, Nov. 6, 2023

WHAT THIS MEANS FOR YOU:

People with multiple sclerosis may be able to take a blood test that can predict how fast their illness progresses, opening new insights into best treatments.

Source: HealthDay