ArticleJournal of neurology2023
Intrathecal kappa free light chain synthesis is associated with worse prognosis in relapsing-remitting multiple sclerosis.
Article in Journal of neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Early Prognostic Factors in Multiple Sclerosis: Clinical and Therapeutic Implications.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Intrathecal Plasma Cell Activity as Measured by the Kappa Free Light Chain Index Is Associated With Retinal Layer Atrophy in Early Multiple Sclerosis.European journal of neurology · 2026Article
- External validation of KFLC index threshold for multiple sclerosis diagnosis in a French cohort.Journal of neurology · 2026Article
- 18:2 Cholesterol Ester is a Novel Prognostic Biomarker of Disease Progression in Multiple Sclerosis.Molecular neurobiology · 2026Article
- An algorithm to predict intrathecal IgM synthesis in multiple sclerosis patients: optimizing the use of oligoclonal band testing.Advances in laboratory medicine · 2026Article
- CSF κ-Free light chain index in suspected multiple sclerosis: diagnostic performance vs. Oligoclonal bands and alignment with 2017/2024 McDonald criteria.Acta neurologica Belgica · 2026Article
- Intrathecal immunoglobulin production in the diagnosis, prognosis, and monitoring of autoimmune diseases of the central nervous system.Journal of translational autoimmunity · 2026Review
- Kappa Index predicts disease activity and transition to high-efficacy therapies in multiple sclerosis.Clinical chemistry and laboratory medicine · 2026Article
- Kappa Free Light Chains Reflect Treatment Response and Progression Independent of Focal Inflammation in Multiple Sclerosis.European journal of neurology · 2026Article
- The Kappa Free Light Chains Index in Multiple Sclerosis: From Emerging Evidence to Clinical Application.Journal of neurochemistry · 2026Article
- Slowly Expanding Lesions in Multiple Sclerosis: A Systematic Review and Meta-Analysis.NeuroSci · 2026Review
- Residual inflammation in the cerebrospinal fluid after short- and long-term natalizumab treatment in relapsing-remitting multiple sclerosis.Frontiers in immunology · 2026Observational
- A novel multiplexed biomarker panel reveals key molecular pathways in progressive multiple sclerosis.Brain communications · 2026Article
- Optimized Kappa-Index Test Protocol to Detect Intrathecal Immunoglobulin Synthesis in Multiple Sclerosis.European journal of neurology · 2025Article
- Kappa free light chain index as a diagnostic and prognostic biomarker in multiple sclerosis.Journal of neurology · 2025Article
- Refining Prognostic Factors in Adult-Onset Multiple Sclerosis: A Narrative Review of Current Insights.International journal of molecular sciences · 2025Review
- B Cell-Derived and Non-B Cell-Derived Free Light Chains: From Generation to Biological and Pathophysiological Roles.International journal of molecular sciences · 2025Review
- Kappa Free Light Chain Index Correlates With Prognostic Biomarkers in Multiple Sclerosis and Decreases Slowly Following Treatment.European journal of neurology · 2025Article
- The Kappa Free Light Chains Index and Central Vein Sign: Two New Biomarkers for Multiple Sclerosis Diagnosis.Neurology and therapy · 2025Review
- Fluid Biomarkers in Demyelinating Spectrum Disorders: Past, Present, and Prospects.International journal of molecular sciences · 2025Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 3 countries.
Funding
Abstract
backgroundWhile kappa free light chain (KFLC) index has become a useful diagnostic biomarker in multiple sclerosis (MS), its prognostic properties are less explored. B cells play a crucial role in MS pathogenesis, but the impact from increased intrathecal production of immunoglobulins and KFLC remains to be determined. Recently, it has become evident that insidious worsening is not confined to progressive MS but is also common in relapsing-remitting MS (RRMS), a feature known as progression independent of relapse activity (PIRA).
methodsWe retrospectively identified 131 patients with clinically isolated syndrome or early RRMS who had determined KFLC index as part of their diagnostic workup. Demographic and clinical data were extracted from the Swedish MS registry. Associations of baseline KFLC index with evidence of disease activity (EDA) and PIRA were investigated in multivariable cox proportional hazards regression models.
resultsKFLC index was significantly higher in PIRA (median 148.5, interquartile range [IQR] 106.9-253.5) compared with non-PIRA (78.26, IQR 28.93-186.5, p = 0.009). In a multivariable cox regression model adjusted for confounders, KFLC index emerged as an independent risk factor for PIRA (adjusted hazard ratio [aHR] 1.005, 95% confidence interval [CI] 1.002-1.008, p = 0.002). Dichotomized by the cut-off value KFLC index > 100, patients with KFLC index > 100 had an almost fourfold increase in the risk for developing PIRA. KFLC index was also predictive of evidence of disease activity during follow-up.
conclusionsOur data indicate that high KFLC index at baseline is predictive of PIRA, EDA-3, and overall worse prognosis in MS.
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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.