Evidence map›Paper›PMID 42429990›Full record

ArticleJournal of neurology2026

From measurement to biomarker trajectories: platform-agnostic Z score analysis of serum NfL and GFAP in ocrelizumab-treated multiple sclerosis.

Hernan Inojosa, Lars Masanneck, Katja Akgün, Ramona Hagler, Sven G Meuth, Carolin Otto, Patrick Schindler, Karin Schulze-Bosse, Jens Kuhle, Pascal Benkert and 3 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

13 authors.

Hernan Inojosa *Center of Clinical Neuroscience, Neurological Clinic, Carl Gustav Carus University Clinic, and Centre for Tactile Internet With Human-in-the-Loop (CeTI), University of Technology, Dresden, Germany.
Lars Masanneck *Department of Neurology and Medical Faculty, University Hospital Düsseldorf (UKD), Düsseldorf, Germany.
Katja AkgünCenter of Clinical Neuroscience, Neurological Clinic, Carl Gustav Carus University Clinic, and Centre for Tactile Internet With Human-in-the-Loop (CeTI), University of Technology, Dresden, Germany.
Ramona HaglerDepartment of Neurology and Medical Faculty, University Hospital Düsseldorf (UKD), Düsseldorf, Germany.
Sven G MeuthDepartment of Neurology and Medical Faculty, University Hospital Düsseldorf (UKD), Düsseldorf, Germany.
Carolin OttoDepartment of Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Humboldt-Universität Zu Berlin, Berlin, Germany.
Patrick SchindlerDepartment of Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Und Humboldt-Universität Zu Berlin, Berlin, Germany.
Karin Schulze-BosseCentral Institute of Clinical Chemistry and Laboratory Diagnostics, University Hospital Düsseldorf, Düsseldorf, Germany.
Jens KuhleUniversity Hospital Basel and University of Basel, Basel, Switzerland.
Pascal BenkertDepartment of Clinical Research, University Hospital Basel, Basel, Switzerland.
Klemens RuprechtDivision of Neuroimmunology, Department of Neurology, University of Heidelberg, Heidelberg, Germany.
Marc Pawlitzki *Department of Neurology and Medical Faculty, University Hospital Düsseldorf (UKD), Düsseldorf, Germany. Marc.Pawlitzki@ukmuenster.de.
Tjalf Ziemssen *Center of Clinical Neuroscience, Neurological Clinic, Carl Gustav Carus University Clinic, and Centre for Tactile Internet With Human-in-the-Loop (CeTI), University of Technology, Dresden, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSerum neurofilament light chain (sNfL) and glial fibrillary acidic protein (sGFAP) are promising multiple sclerosis (MS) biomarkers, but biological confounding and inter-assay variability limit real-world use. We assessed whether Z score normalisation enables platform-agnostic monitoring in people with MS (pwMS) under ocrelizumab, and which early timepoint best stratifies subsequent biomarker trajectories.

methodsThis pooled multicentre analysis of three German cohorts included pwMS treated with ocrelizumab for ≥ 12 months. Elecsys

results430 pwMS were included [78% relapsing MS (RMS), 22% primary progressive MS (PPMS)]. Baseline sNfL Z scores were higher in RMS; sGFAP Z scores were similar. Multivariable analyses linked higher expanded disability status scale to elevation of both biomarkers, while younger age was independently associated with higher sNfL. Following ocrelizumab, sNfL decreased in RMS while sGFAP remained stable. People with RMS and concurrent baseline elevation sustained the highest levels, diverging from the stable PPMS profile. Month-12 combined elevation best predicted persisting 24-month elevation, outperforming baseline and 6-month assessments. Crucially, failing to achieve a ≥ 50% relative reduction at month 12 strongly predicted persistent 24-month elevation for sNfL (OR 7.14, 95% CI 1.35-37.75) and sGFAP (OR 32.08, 95% CI 5.10-201.67).

conclusionsZ score normalisation enabled platform-agnostic framework for MS monitoring of downstream biological trajectories. We identify a practical 12-month exploratory responder threshold: pwMS failing to reach a ≥ 50% relative Z score reduction represent a group with persistent biomarker elevation, supporting closer clinical surveillance.

Indexed as

Antibodies, Monoclonal, HumanizedGlial Fibrillary Acidic ProteinImmunologic FactorsMultiple SclerosisMultiple Sclerosis, Chronic ProgressiveNeurofilament ProteinsAdultBiomarkersCohort StudiesFemaleHumansMaleMiddle AgedAntibodies, Monoclonal, HumanizedBiomarkersGFAP protein, humanGlial Fibrillary Acidic ProteinImmunologic Factorsneurofilament protein LNeurofilament ProteinsocrelizumabGlial fibrillary acidic proteinMultiple sclerosisNeurofilament light chainOcrelizumabSerum biomarkersZ scores

Identifiers

PMID42429990
PMCPMC13354649

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.