Journal Article

DZNE-2024-00182

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Serum glial fibrillary acidic protein and disability progression in progressive multiple sclerosis.

Abdelhak, A. ; Antweiler, K. ; Kowarik, M. C. ; Senel, M. ; Havla, J. ; Zettl, U. K. ; Kleiter, I. ; Skripuletz, T. ; Haarmann, A. ; Stahmann, A. ; Huss, A. ; Gingele, S. ; Krumbholz, M. ; Benkert, P. ; Kuhle, J. ; Friede, T. ; Ludolph, A. C.DZNE* ; Ziemann, U. ; Kümpfel, T. ; Tumani, H.Extern*

2024
Wiley Chichester [u.a.]

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Please use a persistent id in citations: doi:10.1002/acn3.51969

Abstract: Progression prediction is a significant unmet need in people with progressive multiple sclerosis (pwPMS). Studies on glial fibrillary acidic protein (GFAP) have either been limited to single center with relapsing MS or were based solely on Expanded Disability Status Scale (EDSS), which limits its generalizability to state-of-the-art clinical settings and trials applying combined outcome parameters.Serum GFAP and NfL (neurofilament light chain) were investigated in EmBioProMS participants with primary (PP) or secondary progressive MS. Six months confirmed disability progression (CDP) was defined using combined outcome parameters (EDSS, timed-25-foot walk test (T25FW), and nine-hole-peg-test (9HPT)).243 subjects (135 PPMS, 108 SPMS, age 55.5, IQR [49.7-61.2], 135 female, median follow-up: 29.3 months [17.9-40.9]) were included. NfL (age-) and GFAP (age- and sex-) adjusted Z scores were higher in pwPMS compared to HC (p < 0.001 for both). 111 (32.8%) CDP events were diagnosed in participants with ≥3 visits (n = 169). GFAP Z score >3 was associated with higher risk for CDP in participants with low NfL Z score (i.e., ≤1.0) (HR: 2.38 [1.12-5.08], p = 0.025). In PPMS, GFAP Z score >3 was associated with higher risk for CDP (HR: 2.88 [1.21-6.84], p = 0.016). Risk was further increased in PPMS subjects with high GFAP when NfL is low (HR: 4.31 [1.53-12.13], p = 0.006).Blood GFAP may help identify pwPPMS at risk of progression. Combination of high GFAP and low NfL levels could distinguish non-active pwPMS with particularly high progression risk.

Keyword(s): Male (MeSH) ; Humans (MeSH) ; Female (MeSH) ; Middle Aged (MeSH) ; Multiple Sclerosis (MeSH) ; Glial Fibrillary Acidic Protein (MeSH) ; Intermediate Filaments (MeSH) ; Biomarkers (MeSH) ; Neoplasm Recurrence, Local (MeSH) ; Multiple Sclerosis, Chronic Progressive: diagnosis (MeSH) ; GFAP protein, human ; Glial Fibrillary Acidic Protein ; Biomarkers

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Contributing Institute(s):

1. Clinical Study Center Ulm (Clinical Study Center Ulm)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2024

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