ArticleJournal of neurology, neurosurgery, and psychiatry2022
Plasma neurofilament light chain levels suggest neuroaxonal stability following therapeutic remyelination in people with multiple sclerosis.
Article in Journal of neurology, neurosurgery, and psychiatry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02040298 (A Phase II Randomized, Double-Blind, Parallel-Group, Placebo Controlled Crossover Trial to Assess the Efficacy, Safety, Tolerability, and Pharmacokinetics of Clemastine Fumarate as a Remyelinating Agent in Multiple Sclerosis), which is not on this map. Cited by 18 papers.
What it found
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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.
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.
A Phase II Randomized, Double-Blind, Parallel-Group, Placebo Controlled Crossover Trial to Assess the Efficacy, Safety, Tolerability, and Pharmacokinetics of Clemastine Fumarate as a Remyelinating Agent in Multiple Sclerosis
Who cites it
18 citing papers in PubMed, 29 citations in OpenAlex.
- Use of blood-based neurofilament light chain as an endpoint in clinical trials of neurodegenerative conditions: a scoping review.Journal of neurology · 2026Article
- Article
- Clemastine fumarate promotes myelin repair in a nonhuman primate model of demyelination characterized by absent spontaneous remyelination.Proceedings of the National Academy of Sciences of the United States of America · 2026Article
- Remyelination therapies are achievable in clinical practice-Yes.Multiple sclerosis (Houndmills, Basingstoke, England) · 2026Article
- Article
- Spironolactone Targets Retinoid X Receptor γ to Promote Myelin Sheath Regeneration.Neurology(R) neuroimmunology & neuroinflammation · 2025Article
- Investigating the impact of age on neurodegeneration after optic neuritis in multiple sclerosis using optical coherence tomography.Multiple sclerosis (Houndmills, Basingstoke, England) · 2025Article
- Markers of axonal injury in blood and tissue triggered by acute and chronic demyelination.Brain : a journal of neurology · 2025Article
- Vitamin B12 Levels Association with Functional and Structural Biomarkers of Central Nervous System Injury in Older Adults.Annals of neurology · 2025Article
- The role of Neurofilament light (NfL) and glial fibrillary acidic protein (GFAP) in MS and AQP4-NMOSD: Advancing clinical applications.eNeurologicalSci · 2025Review
- Prophylactic clemastine treatment improves influenza A virus-induced cognitive dysfunction in mice.Brain, behavior, & immunity - health · 2024Article
- Remyelination protects neurons from DLK-mediated neurodegeneration.Nature communications · 2024Article
- Remyelination protects neurons from DLK-mediated neurodegeneration.bioRxiv : the preprint server for biology · 2024Article
- Pipe dream: Remyelination therapy for multiple sclerosis.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Synaptic injury in the inner plexiform layer of the retina is associated with progression in multiple sclerosis.Cell reports. Medicine · 2024Article
- Mechanisms of Demyelination and Remyelination Strategies for Multiple Sclerosis.International journal of molecular sciences · 2023Review
- Insights on therapeutic potential of clemastine in neurological disorders.Frontiers in molecular neuroscience · 2023Review
- The 2022 Lady Estelle Wolfson lectureship on neurofilaments.Journal of neurochemistry · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundChronic demyelination is a major contributor to axonal vulnerability in multiple sclerosis (MS). Therefore, remyelination could provide a potent neuroprotective strategy. The ReBUILD trial was the first study showing evidence for successful remyelination following treatment with clemastine in people with MS (pwMS) with no evidence of disease activity or progression (NEDAP). Whether remyelination was associated with neuroprotection remains unexplored.
methodsPlasma neurofilament light chain (NfL) levels were measured from ReBUILD trial's participants. Mixed linear effect models were fit for individual patients, epoch and longitudinal measurements to compare NfL concentrations between samples collected during the active and placebo treatment period.
resultsNfL concentrations were 9.6% lower in samples collected during the active treatment with clemastine (n=53, geometric mean=6.33 pg/mL) compared to samples collected during treatment with placebo (n=73, 7.00 pg/mL) (B=-0.035 [-0.068 to -0.001], p=0.041). Applying age- and body mass index-standardised NfL Z-scores and percentiles revealed similar results (0.04 vs 0.35, and 27.5 vs 33.3, p=0.023 and 0.042, respectively). Higher NfL concentrations were associated with more delayed P100 latencies (B=1.33 [0.26 to 2.41], p=0.015). In addition, improvement of P100 latencies between visits was associated with a trend for lower NfL values (B=0.003 [-0.0004 to 0.007], p=0.081). Based on a Cohen's d of 0.248, a future 1:1 parallel-arm placebo-controlled study using a remyelinating agent with comparable effect as clemastine would need 202 subjects per group to achieve 80% power.
conclusionsIn pwMS, treatment with the remyelinating agent clemastine was associated with a reduction of blood NfL, suggesting that neuroprotection is achievable and measurable with therapeutic remyelination. TRIAL REGISTRATION NUMBER: NCT02040298.
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Registered trials
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.