Neurology Central

Biomarker discovery and development in multiple sclerosis: where are we now?

Robert Fox is a staff neurologist at the Mellen Center for Multiple Sclerosis at the Cleveland Clinic (OH, USA), which is now one of the largest and most comprehensive programs for multiple sclerosis (MS) care and research worldwide.
In this interview, Robert speaks to us about serum neurofilament light (sNfL) as a blood biomarker for MS. He also speaks to us about the key advances of biomarker discovery and development in MS, including what the challenges involved with developing biomarkers are for this field.

What is your current research focus and what inspired you to work in the field?

My research has focused on biomarkers of MS and focusing on imaging biomarkers as applied to clinical trials. More recently, I’ve become interested in blood markers as well and understanding what blood markers may be useful in predicting treatment response, and identify patients who have active disease.

You presented a talk at ECTRIMS (10–12 October 2018, Berlin, Germany) on the clinical relevance of sNfL – could you provide a brief overview about this for us?

I actually did a talk and a poster on sNfL, so I can summarize them both together. The talk provides an overview of how sNfL relates to disease, how it relates to active inflammation (as measured by MRI and T2 lesion burden), how it measures when the disease gets active, and how it’s also predictive of future disease activity and disability. This talk also develops the idea of a cutoff at a level of 16 pg/ml (measured by a Simoa® assay [Quanterix®, MA, USA]) as a threshold that suggests disease activity, and does correlate with active disease on MRI.

What have been the key advances of biomarker discovery and development for MS?

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