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Abstract Details

Serum Glial Fibrillary Acidic Protein compared with Neurofilament Light Chain as Biomarker for Multiple Sclerosis Disease Progression
Multiple Sclerosis
P5 - Poster Session 5 (11:45 AM-12:45 PM)
3-016

There are insufficient diagnostic tools to anticipate ‘pure progression’ and acute inflammation in MS. 

To compare how serum glial fibrillary acidic protein (sGFAP) and neurofilament light chain (sNfL) correlate with progression and acute inflammation in multiple sclerosis (MS).

sGFAP and sNfL were measured using Simoa assays in three cohorts of patients of the Swiss MS Cohort: 1) worsening progressive MS (wPMS; 184 samples (s)/18 patients (p), median follow-up (FU): 6.5 years (y), median EDSS baseline (BL)/last visit 4.0/6.0); 2) clinically stable MS (stMS; 169s/19p, 7.1 y, EDSS 3.0/2.5) (both relapse-free during FU); 3) Relapsing MS (132s/66p) during a) acute disease activity (relapse/contrast enhancing lesions); 66s) and b) stable phase (66s); and healthy controls (HC; 485s/259p; BL and 1y FU). Multivariable mixed models were applied to longitudinally compare log-transformed sGFAP/sNfL between groups 1) versus 2); 3a) versus 3b); and adjusted mixed/Cox regression models for the association between BL sGFAP/sNfL levels and brain volume loss (BVL) and time to confirmed disability worsening (CDW) in groups 1) and 2). 

sGFAP increased in HC with age (1.5%/y, p<0.001), decreased with body mass index (-1.1%/BMI unit, p=0.015) and was 15% higher in women than men (p=0.004). wPMS patients showed 57% higher sGFAP levels versus stMS (p=0.006) and remained 51% higher after sNfL adjustment in the model (p=0.010). In contrast, the 25% increase of sNfL in wPMS versus stMS (p=0.046) disappeared after sGFAP adjustment. Acute disease activity had no effect on sGFAP, while it increased sNfL by 53% (p<0.001). Higher sGFAP at BL was associated with accelerated gray matter BVL (per doubling (pd): 0.24%, p<0.0001), but not white matter (p=0.48). sGFAP, but not sNfL levels were associated with shorter time to CDW (HR pd: 3.63, p=0.006; HR pd: 1.90, p=0.112). 

sGFAP may be a more specific biomarker for ‘pure progression’ than sNfL.

Authors/Disclosures
Stephanie Victoria Meier
PRESENTER
Miss Meier has nothing to disclose.
Pascal Benkert Pascal Benkert has nothing to disclose.
Aleksandra Maleska Maceski Aleksandra Maleska Maceski has nothing to disclose.
Sabine Schaedelin Sabine Schaedelin has nothing to disclose.
Johanna Oechtering, MD The institution of Dr. Oechtering has received research support from Swiss MS Society.
Lester Melie-Garcia, PhD (University of Basel, Department of Biomedical Engineering) Dr. Melie-Garcia has nothing to disclose.
Alessandro Cagol, MD Dr. Cagol has nothing to disclose.
Muhamed Barakovic, PhD Mr. Barakovic has nothing to disclose.
Riccardo Galbusera, MD Dr. Galbusera has nothing to disclose.
Lutz Achtnichts, MD (Kantonsspital Aarau) No disclosure on file
Patrice LaLive, MD Dr. LaLive has nothing to disclose.
Claire Bridel Claire Bridel has nothing to disclose.
Stefanie Mueller-Schunk (Kantonsspital St. Gallen) Stefanie Mueller-Schunk has nothing to disclose.
Caroline Pot Caroline Pot has nothing to disclose.
Anke Salmen (St. Josef-Hospital, Ruhr -University Bochum) The institution of Anke Salmen has received research support from Baasch Medicus Foundation. The institution of Anke Salmen has received research support from Swiss MS Society. The institution of Anke Salmen has received research support from Medical Faculty of the University of Bern. Anke Salmen has received personal compensation in the range of $500-$4,999 for serving as a speaker with Bristol Myers Squibb, CSL Behring, Novartis, Roche.
Giulio Disanto, MD, PhD (Neurologia, Ospedale Civico) The institution of Dr. Disanto has received research support from Swiss MS Sociery.
Chiara Claudia Zecca, MD (Ente ospedaliero cantonale) The institution of Dr. Zecca has received research support from Ente Ospedaliero Cantonale.
Ahmed Mohamed Taha Abdelhak, MD (UCSF Weill Institute of Neuroscience) The institution of Dr. Abdelhak has received research support from German Multiple Sclerosis Society.
Christian Barro, MD, PhD (Brigham and Women's Hospital) Dr. Barro has nothing to disclose.
Simon Thebault, MD (University of Pennsylvania, Department of Medicine) Dr. Thebault has nothing to disclose.
Marcus D'Souza, MD (University-Hospital-Basel) Dr. D'Souza has nothing to disclose.
Tobias Derfuss An immediate family member of Tobias Derfuss has received personal compensation for serving as an employee of Novartis. The institution of Tobias Derfuss has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. The institution of Tobias Derfuss has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. The institution of Tobias Derfuss has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. The institution of Tobias Derfuss has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. The institution of Tobias Derfuss has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. The institution of Tobias Derfuss has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GeNeuro. Tobias Derfuss has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MedDay. Tobias Derfuss has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Tobias Derfuss has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Actelion. Tobias Derfuss has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Merck. Tobias Derfuss has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Roche. An immediate family member of Tobias Derfuss has received stock or an ownership interest from Novartis. The institution of Tobias Derfuss has received research support from Roche. The institution of Tobias Derfuss has received research support from Biogen.
Annette Orleth Dr. Orleth has nothing to disclose.
Michael Khalil Michael Khalil has nothing to disclose.
Oezguer Yaldizli, MD Dr. Yaldizli has nothing to disclose.
Marco Hermesdorf Dr. Hermesdorf has nothing to disclose.
Heinz Wiendl, MD, FAAN (University of Muenster) Dr. Wiendl has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Wiendl has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Wiendl has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Wiendl has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Wiendl has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Immunovant. Dr. Wiendl has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Johnson&Johnson / Janssen. Dr. Wiendl has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. Dr. Wiendl has received personal compensation in the range of $0-$499 for serving as a Consultant for Idorsia. Dr. Wiendl has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Argenx. Dr. Wiendl has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Immunic. Dr. Wiendl has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Wiendl has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NexGen. Dr. Wiendl has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Worldwide Clinical Trials. Dr. Wiendl has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BD. Dr. Wiendl has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Wiendl has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gossamer Bio. Dr. Wiendl has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for LTS. Dr. Wiendl has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Samsung. Dr. Wiendl has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sangamo. Dr. Wiendl has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck Serono. Dr. Wiendl has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Wiendl has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Dr. Wiendl has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Wiendl has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx. Dr. Wiendl has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Wiendl has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sandoz. Dr. Wiendl has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sandoz-Hexal. Dr. Wiendl has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cellerys. Dr. Wiendl has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Dianthus. Dr. Wiendl has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Toleranzia. Dr. Wiendl has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Uniqure. The institution of Dr. Wiendl has received research support from Biogen. The institution of Dr. Wiendl has received research support from Roche. The institution of Dr. Wiendl has received research support from Deutsche Forschungsgemeinschaft. The institution of Dr. Wiendl has received research support from European Union. The institution of Dr. Wiendl has received research support from Argenx. The institution of Dr. Wiendl has received research support from CSL Behring. The institution of Dr. Wiendl has received research support from Merck. The institution of Dr. Wiendl has received research support from UCB. Dr. Wiendl has received publishing royalties from a publication relating to health care. Dr. Wiendl has received publishing royalties from a publication relating to health care.
Fredrik L. Piehl, MD,PhD (Neuroimmunology Unit, Dept Clinical Neuroscience, Karolinska Institutet) Dr. Piehl has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Parexel/Chugai. The institution of Dr. Piehl has received research support from UCB. The institution of Dr. Piehl has received research support from Merck KGaA. Dr. Piehl has received personal compensation in the range of $10,000-$49,999 for serving as a member scientific advisory board with Swedish Medical products Agency.
Urs Martin Fischer, MD, PA (University Hospital Basel, Neurology) The institution of Urs Fischer has received research support from Medtronic. The institution of Urs Fischer has received research support from Medtronic.
Ludwig Kappos, MD, FAAN ( RC2NB, University Hospital Basel) The institution of Dr. Kappos has received research support from Bayer. The institution of Dr. Kappos has received research support from Biogen. The institution of Dr. Kappos has received research support from Genentech. The institution of Dr. Kappos has received research support from Genzyme. The institution of Dr. Kappos has received research support from Janssen. The institution of Dr. Kappos has received research support from Merck Serono. The institution of Dr. Kappos has received research support from Minoryx. The institution of Dr. Kappos has received research support from Novartis. The institution of Dr. Kappos has received research support from Roche. The institution of Dr. Kappos has received research support from Sanofi. The institution of Dr. Kappos has received research support from Santhera. The institution of Dr. Kappos has received research support from Swiss MS Society, Swiss National Research Foundation, European Union, Roche Research Foundation, Innosuisse. The institution of Dr. Kappos has received research support from Shionogi. The institution of Dr. Kappos has received research support from Japan Tobacco. The institution of Dr. Kappos has received research support from Auriga Vision AG. The institution of Dr. Kappos has received research support from EMD Serono. The institution of Dr. Kappos has received research support from Glaxo Smith Kline. The institution of Dr. Kappos has received research support from Wellmera AG. The institution of Dr. Kappos has received research support from Eli Lilly (Suisse) SA. The institution of Dr. Kappos has received research support from Bristol Myers Squibb. The institution of Dr. Kappos has received research support from Celltrion Inc. Dr. Kappos has received intellectual property interests from a discovery or technology relating to health care.
Claudio Gobbi, MD (Ospedale Regionale Lugano) The institution of Dr. Gobbi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie, Almirall, Biogen Idec, Celgene, Sanofi, Merck, Novartis, Teva Pharma, Roche.. Dr. Gobbi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie, Almirall, Biogen Idec, Celgene, Sanofi, Merck, Novartis, Teva Pharma, Roche..
Cristina Granziera, MD, PhD (Basel University Hospital) Dr. Granziera has nothing to disclose.
David Leppert, MD (University Hospital Basel) Dr. Leppert has received personal compensation for serving as an employee of GeNeuro. Dr. Leppert has received personal compensation for serving as an employee of GeNeuro. Dr. Leppert has received personal compensation for serving as an employee of Geneuro. Dr. Leppert has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Leppert has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Leppert has received personal compensation in the range of $0-$499 for serving as a Consultant for Orion. Dr. Leppert has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Dr. Leppert has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Quanterix. Dr. Leppert has stock in Novartis.
Eline AJ Willemse, PhD (University Hospital Basel) Dr. Willemse has nothing to disclose.
Jens Kuhle, MD Dr. Kuhle has nothing to disclose.