The FDA has granted the plasma NFL assay Breakthrough Device designation as a prognostic aid in assessing patients with relapsing-remitting MS. What does this mean for me?
If it doesn’t measure the smouldering disease, why would we want it to be approved? Since the majority of disability isn’t predicted by lesions and relapses (inflammatory disease) this sounds like it would not at all be similar to c-reactive protein in RA. Neurologists are already too focused on radiologic activity, it would be terrible if we now enter an era where neurologists start insisting a patient’s MS is under control just because the sNfL curve is flat…
Sadly the majority of disability is not predicted by relapse and MRI activity. If it was we wouldn't have people who are NEIDA developing progressive MS. In fact very little of disability is predicted by relapses and MRI activity, which is why they are not the disease.
I have been asking myself whether, when/if the assay works its way through the various Circumlocution Offices to a NICE thumbs-up, whether it may displace or spell the end of the increasingly blunt-looking tool of the annual MRI?
If it doesn’t measure the smouldering disease, why would we want it to be approved? Since the majority of disability isn’t predicted by lesions and relapses (inflammatory disease) this sounds like it would not at all be similar to c-reactive protein in RA. Neurologists are already too focused on radiologic activity, it would be terrible if we now enter an era where neurologists start insisting a patient’s MS is under control just because the sNfL curve is flat…
Sadly the majority of disability is not predicted by relapse and MRI activity. If it was we wouldn't have people who are NEIDA developing progressive MS. In fact very little of disability is predicted by relapses and MRI activity, which is why they are not the disease.
I have been asking myself whether, when/if the assay works its way through the various Circumlocution Offices to a NICE thumbs-up, whether it may displace or spell the end of the increasingly blunt-looking tool of the annual MRI?
... which would presumably free up a useful chunk of change the NHS might then be able to spend on, say, wider autologous stem cell treatments?
CRP is not a good MS biomarker. I refer to CRP being used in rheumatoid arthritis. The MS biomarker is NFL.
I thought I read that, thanks for your reply :)