Q&A 17 - beyond no evident inflammatory disease activity or NEIDA

Questions

Dear Prof G

I am 33 years of age and have had MS for just over seven years. I was on dimethyl fumarate (Tecfidera) for four years and started ocrelizumab (Ocrevus) three years ago. Ocrelizumab has been very kind to me; I have tolerated it without infection. Since starting ocrelizumab, I have been relapse-free, and my annual MRI scans have been stable, but I am now getting worse. Over the last 18 months, my walking has deteriorated due to a right foot drop, and my bladder function is awful. My neurologist wants me to have a lumbar puncture to measure my spinal fluid neurofilament level before potentially offering me a more effective therapy. I don’t want to have a lumbar puncture.

Q1: Is it possible to have a blood neurofilament level done in the UK instead? 

Q2: Will measuring spinal fluid neurofilament level make a difference to my management? Thank you. 

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Answers

Beyond NEIDA - triangulating the MS treatment target

Q1: Is it possible to have a blood neurofilament level done in the UK instead?