Fingolimod reduced neurofilament-light chain levels in the cerebrospinal fluid of patients with relapsing-remitting multiple sclerosis who participated in the 2-year, phase III FREEDOMS study, according to Dr. Jens Kuhle and associates.
At baseline, the placebo group had a median NfL level of 886 pg/mL, while the fingolimod group (at doses of 0.5 mg or 1.25 mg) had a median level of 652 pg/mL. After 12 months, the median value for the fingolimod group had decreased significantly to 335 pg/mL. The median value in the placebo group decreased slightly to 738 pg/mL, but this was not a significant reduction. A lower NfL level after 12 months was also correlated with a lower rate of relapse and improved MRI outcomes.
The study results “support the need for future larger scale studies including CSF sampling and investigating easier accessible compartments like peripheral blood to further examine the utility of NfL levels as a potential biomarker in MS,” the investigators concluded.
In a related editorial, Dr. Bibiana Bielekova and Michael McDermott, Ph.D., wrote, “This correlation with clinical experience is encouraging, as it indicates that NfL may capture relevant biology directly related to the development of neurologic disability in MS.”
Find the full study (doi:10.1212/WNL.0000000000001491) and editorial (doi: 10.1212/WNL.0000000000001506) in Neurology.