Evidence map›Paper›PMID 34504023›Full record

Observational studyNeurology2021

Serum Neurofilament Light Association With Progression in Natalizumab-Treated Patients With Relapsing-Remitting Multiple Sclerosis.

Claire Bridel, Cyra E Leurs, Zoë Y G J van Lierop, Zoé L E van Kempen, Iris Dekker, Harry A M Twaalfhoven, Bastiaan Moraal, Frederik Barkhof, Bernard M J Uitdehaag, Joep Killestein and 1 more

Open access · bronzeAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 2 pooled it
5.9field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.

  1. Prognostic value of neurofilament light chain protein and glial fibrillary acidic protein in multiple sclerosis subtypes and disease activity patterns: a systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
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  19. Neuroaxonal and Glial Markers in Patients of the Same Age With Multiple Sclerosis.Neurology(R) neuroimmunology & neuroinflammation · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Claire BridelFrom the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland. claire.bridel@hcuge.ch.ORCID 0000-0001-7267-7676
Cyra E LeursFrom the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland.ORCID 0000-0001-5324-5640
Zoë Y G J van LieropFrom the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland.ORCID 0000-0003-3200-8966
Zoé L E van KempenFrom the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland.
Iris DekkerFrom the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland.ORCID 0000-0002-8987-9212
Harry A M TwaalfhovenFrom the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland.
Bastiaan MoraalFrom the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland.
Frederik BarkhofFrom the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland.ORCID 0000-0003-3543-3706
Bernard M J UitdehaagFrom the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland.
Joep KillesteinFrom the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland.
Charlotte E TeunissenFrom the Clinical Chemistry Laboratory (C.B., H.A.M.T., C.E.T.), Department of Neurology (C.E.L., Z.Y.G.J.v.L., Z.L.E.v.K., I.D., B.M.J.U., J.K.), and Department of Radiology (B.M., F.B.), Amsterdam UMC, the Netherlands; and Department of Neurology (C.B.), Geneva University Hospital, Switzerland.ORCID 0000-0002-4061-0837
European Organisation for Research and Treatment of Cancer · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesTo investigate the potential of serum neurofilament light (NfL) to reflect or predict progression mostly independent of acute inflammatory disease activity in patients with relapsing-remitting multiple sclerosis (RRMS) treated with natalizumab.

methodsPatients were selected from a prospective observational cohort study initiated in 2006 at the VU University Medical Center Amsterdam, the Netherlands, including patients with RRMS treated with natalizumab. Selection criteria included an age of 18 years or older and a minimum follow-up of 3 years from natalizumab initiation. Clinical and MRI assessments were performed on a yearly basis, and serum NfL was measured at 5 time points during the follow-up, including on the day of natalizumab initiation (baseline), 3 months, 1 year, and 2 years after natalizumab initiation, and on last follow-up visit. Using general linear regression models, we compared the longitudinal dynamics of NfL between patients with and without confirmed Expanded Disability Status Scale (EDSS) progression between year 1 visit and last follow-up, and between individuals with and without EDSS

resultsEighty-nine natalizumab-treated patients with RRMS were included. Median follow-up time was 5.2 years (interquartile range [IQR] 4.3-6.7, range 3.0-11.0) after natalizumab initiation, mean age at time of natalizumab initiation was 36.9 years (SD 8.5), and median disease duration was 7.4 years (IQR 3.8-12.1). Between year 1 and the last follow-up, 28/89 (31.5%) individuals showed confirmed EDSS progression. Data for the EDSS

conclusionIn our cohort of natalizumab-treated patients with RRMS, NfL fails to capture or predict progression that occurs largely independently of clinical or radiologic signs of acute focal inflammatory disease activity. Additional biomarkers may thus be needed to monitor progression in these patients. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that serum NfL levels are not associated with disease progression in natalizumab-treated patients with RRMS.

Indexed as

Multiple SclerosisMultiple Sclerosis, Relapsing-RemittingAdolescentDisease ProgressionHumansImmunologic FactorsIntermediate FilamentsNatalizumabProspective StudiesImmunologic FactorsNatalizumab

Identifiers

PMID34504023
OpenAlexW3198417252

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.