Association of plasma neurofilament light chain with disease activity in chronic inflammatory demyelinating polyradiculoneuropathy. (25th July 2022)

• Record Type: Journal Article
• Authors: Kapoor, Mahima; Carr, Aisling; Foiani, Martha; Heslegrave, Amanda; Zetterberg, Henrik; Malaspina, Andrea; Compton, Laura; Hutton, Elspeth; Rossor, Alexander; Reilly, Mary M.; Lunn, Michael P.
• Is Part Of: European journal of neurology. Volume 29:Number 11(2022)
• Page Start: 3347
• Page End: 3357
• Publication Date: 2022-07-25
• Subjects: CIDP -- disease activity -- IVIg -- neurofilament light chain; Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ene.15496
• Languages: English
• ISSNs: 1351-5101

Abstract

Abstract: Background and purpose: This study was undertaken to explore associations between plasma neurofilament light chain (pNfL) concentration (pg/ml) and disease activity in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and examine the usefulness of pNfL concentrations in determining disease remission. Methods: We examined pNfL concentrations in treatment‐naïve CIDP patients ( n = 10) before and after intravenous immunoglobulin (IVIg) induction treatment, in pNfL concentrations in patients on maintenance IVIg treatment who had stable ( n = 15) versus unstable disease ( n = 9), and in clinically stable IVIg‐treated patients ( n = 10) in whom we suspended IVIg to determine disease activity and ongoing need for maintenance IVIg. pNfL concentrations in an age‐matched healthy control group were measured for comparison. Results: Among treatment‐naïve patients, pNfL concentration was higher in patients before IVIg treatment than healthy controls and subsequently reduced to be comparable to control group values after IVIg induction. Among CIDP patients on IVIg treatment, pNfL concentration was significantly higher in unstable patients than stable patients. A pNFL concentration > 16.6 pg/ml distinguished unstable treated CIDP from stable treated CIDP (sensitivity = 86.7%, specificity = 66.7%, area under receiver operating characteristic curve = 0.73). Among the treatment withdrawal group, there was a statistically significant correlation between pNfL concentration at time of IVIg withdrawal and the likelihood of relapse ( r = 0.72, p < 0.05), suggesting an association of higher pNfL concentration with active disease. Conclusions: pNfL concentrations may be a sensitive, clinically useful biomarker in assessing subclinical disease activity. Abstract : We explored the utility of plasma neurofilament light chain concentration (pNfL) in assessing disease activity in a cohort of patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) on maintenance intravenous immunoglobulin (IVIg). We demonstrated that pNfL concentration was significantly higher in unstable patients than stable patients. A pNFL concentration > 16.6 pg/ml identified unstable treated CIDP from stable treated CIDP. Also, there was statistically significant correlation between pNfL concentration at time of IVIg withdrawal and the likelihood of relapse ( r = 0.72, p < 0.05), suggesting an association of higher pNfL concentration with active disease.