EAN 2026 | NfL and GFAP for individualised treatment in MS: two independent large observational cohorts

We, for this study, used the quite remarkable setting of the Swiss multiple sclerosis cohort, where there are eight big MS centers and more than 2,000 patients that are followed for the first one since 2012. And we have longitudinal serum samples of those patients for measuring neurofilament light chain and GFAP in serum and we then tried to look in this quite heterogeneous patient cohort how those biomarkers can provide information on future disease course. And so we saw actually that having a, and this is in more than 12,000 serum samples, that having an elevated value of neurofilament light chain at a single time point is associated with a two-fold risk increase of having a relapse at the next visit, so this is for the acute part of the disease. And we saw that for GFAP which is glial fibrillary acidic protein an elevation above Z-score of one at a single time point in the same cohort is associated with about a 40% risk increase of having a progression event, a PR event, at the next visit. And then we had the opportunity to validate those main findings in the Californian cohort of the UCSF in San Francisco, a cohort called EPIC, which provided also more than 5,000 serum samples and showed more or less the same results. And the other very important point of the study was to look at responses to treatment. So we saw that MS patients that started a treatment with fingolimod or B-cell depleting treatment. Depending on the dynamic of GFAP during the first two years under treatment, we had a very different risk profile of having future progression events. So patients that had a decrease of GFAP during the first two years under treatment had two times less risk of having a progression event in the future. So that’s the other main result of the study.

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