Evidence map›Paper›PMID 40169784›Full record

ArticleScientific reports2025

Neurodegenerative and neuroinflammatory changes in SOD1-ALS patients receiving tofersen.

Cecilia Simonini, Elisabetta Zucchi, Ilaria Martinelli, Giulia Gianferrari, Christian Lunetta, Gianni Sorarù, Francesca Trojsi, Roberta Pepe, Rachele Piras, Matteo Giacchino and 2 more

Abstract readMulticenter Study
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

18 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Safety profile of tofersen in amyotrophic lateral sclerosis: a systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Pooled it
  2. Review
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  7. Longitudinal CSF and Serum Biomarker Dynamics in Tofersen-TreatedInternational journal of molecular sciences · 2026
    Article
  8. Elimination of senescent cells fails to attenuate disease progression in an ALS mouse model.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Cecilia SimoniniDepartment of Neurosciences, Ospedale Civile Baggiovara, Azienda Ospedaliero Universitaria di Modena, Modena, Italy.
Elisabetta ZucchiDepartment of Neurosciences, Ospedale Civile Baggiovara, Azienda Ospedaliero Universitaria di Modena, Modena, Italy. elisabetta.zucchi@unimore.it.
Ilaria MartinelliDepartment of Neurosciences, Ospedale Civile Baggiovara, Azienda Ospedaliero Universitaria di Modena, Modena, Italy.
Giulia GianferrariDepartment of Neurosciences, Ospedale Civile Baggiovara, Azienda Ospedaliero Universitaria di Modena, Modena, Italy.
Christian LunettaNeurorehabilitation Department, Istituti Clinici Scientifici Maugeri IRCCS, Milan Institute, 20138, Milan, Italy.
Gianni SorarùDepartment of Neurosciences, Neuromuscular Center, University of Padua, Padua, Italy.
Francesca TrojsiDepartment of Advanced Medical and Surgical Sciences, MRI Research Center, Luigi Vanvitelli Campania University, Naples, Italy.
Roberta PepeDepartment of Advanced Medical and Surgical Sciences, MRI Research Center, Luigi Vanvitelli Campania University, Naples, Italy.
Rachele PirasNeurorehabilitation Department, Istituti Clinici Scientifici Maugeri IRCCS, Milan Institute, 20138, Milan, Italy.
Matteo GiacchinoDepartment of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Federico BanchelliDepartment of Neurosciences, Ospedale Civile Baggiovara, Azienda Ospedaliero Universitaria di Modena, Modena, Italy.
Jessica MandrioliDepartment of Neurosciences, Ospedale Civile Baggiovara, Azienda Ospedaliero Universitaria di Modena, Modena, Italy.

Funding

Fondazione Cassa di Risparmio di Modena Neurobiobanca di ModenaMinistero della Salute Ricerca Corrente funding scheme of the Italian Ministry of HealthMinistero della Salute Ricerca Finalizzata bando 2021 (RF-2021-12373036)Università Degli Studi di Modena e Reggio Emila bando FAR 2021, Progetti di ricerca Interdisciplinari Mission Oriented, NEURALS project)
6 · The paper itself

Abstract

The initiation of tofersen, a new specific antisense oligonucleotide (ASO) for SOD1 pathology, marked a significant turning point for SOD1-ALS patients. While clinical trials and early access program studies reported a significant reduction in plasma and cerebrospinal fluid (CSF) neurofilament levels, neuroinflammation following prolonged treatment was never assessed. In this multicenter study, we evaluated a cohort of 18 SOD1-ALS patients treated with tofersen, analyzing correlations between biomarkers of neurodegeneration/neuroinflammation and clinical variables indicative of disease progression. NfL, NfH, CHI3L1, and Serpina1 levels in serum and CSF were determined by semi-automated immunoassays (Ella™ technology). Generalized linear mixed models were employed to investigate longitudinal trends of these biomarkers. Our data highlighted a progressive decrease in CSF neurofilament levels during tofersen treatment (MR = 0.97, 95% CI 0.94-0.99, p = 0.006 and MR = 0.98, 95% CI 0.95-1.00, p = 0.076 for NfL and NfH in CSF, respectively). Conversely, CSF levels of SerpinA1 and CHI3L1 increased over time (MR = 1.12, 95% CI 1.08-1.16, p < 0.0001 and MR = 1.039, 95% CI 1.015-1.062, p = 0.001 for SerpinA1 and CHI3L1 in CSF, respectively), but these modifications were most apparent after six and twelve months of therapy, respectively. Disease progression rate did not correlate with these biomarker trends. We observed a significant decrease in neurofilament levels during Tofersen treatment, alongside an increase in neuroinflammatory markers, potentially linked to an immune response triggered by ASO treatment. Given the limited data on tofersen's long-term efficacy in ALS due to its recent introduction, identifying biomarkers that predict clinical outcomes such as diminished therapeutic response or adverse effects is crucial. These biomarkers may help to better understand the underlying pathomechanisms of ALS and tofersen's role in modulating disease progression.

Indexed as

Amyotrophic Lateral SclerosisNeuroinflammatory DiseasesOligonucleotidesSuperoxide Dismutase-1AdultAgedalpha 1-AntitrypsinBiomarkersChitinase-3-Like Protein 1Disease ProgressionFemaleHumansMaleMiddle AgedNeurofilament Proteinsalpha 1-AntitrypsinBiomarkersCHI3L1 protein, humanChitinase-3-Like Protein 1neurofilament protein LNeurofilament ProteinsOligonucleotidesSERPINA1 protein, humanSOD1 protein, humanSuperoxide Dismutase-1tofersenALSCHI3L1NeurofilamentsSerpinA1Tofersen

Identifiers

PMID40169784
PMCPMC11961715

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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.