Serum GFA Identified as a Biomarker for NMOSD, sNfL as a Predictor of Poor Post-Attack Outcomes

Bruce Cree, MD, PhD, MAS, FAAN

Recently published findings suggest that serum glial fibrillary acidic protein (sGFAP) may serve as a biomarker for neuromyelitis optic spectrum disorder (NMOSD), and serum neurofilament light chain (sNfL) may act as a predictor of poor outcomes after attacks. Investigators further concluded that while new radiographic lesions are typically associated with clinical NMOSD attacks, there was a large number of asymptomatic contrast-enhancing events in NMOSD.1 

Findings were presented by Bruce Cree, MD, PhD, MAS, FAAN, clinical research director of the UCSF Multiple Sclerosis Center, and professor of clinical neurology, UCSF Weill Institute for Neuroscience, at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2022, February 24-26, in West Palm Beach, Florida. To investigate relationships between serum biomarkers, cerebrospinal fluid biomarkers, and clinical and radiographic disease activity in NMOSD, further determining the impact of treatments on these biomarkers and outcomes, Cree et al performed a systematic literature review.

Seven randomized controlled trials in NMOSD were identified, including: PREVENT (NCT01892345), which evaluated eculizumab (Soliris; Alexion) vs placebo, with an add-on study design(open-label extension; NCT02003144); SAkura-Sky (NCT02028884), which evaluated satralizumab (Enspryng; Genentech) vs placebo, as an add-on study; SAkura-Star (NCT02073279), which evaluated satralizumab vs placebo; N-MOmentum (NCT02200770), which evaluated inebilizumab (Uplizna; Horizon) vs placebo; RIN-1, which evaluated rituximab (Rituxan; Genentech) vs placebo; TANGO (NCT03350633), which evaluated tocilizumab (Actmera; Genentech)vs azathioprine, open-label; and the Kashani Hospital Study, which evaluated rituximab vs azathioprine, in single-center, open-label fashion.

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