Serum Glial Fibrillary Acidic Protein: A Neuromyelitis Optica Spectrum Disorder Biomarker.


Journal

Annals of neurology
ISSN: 1531-8249
Titre abrégé: Ann Neurol
Pays: United States
ID NLM: 7707449

Informations de publication

Date de publication:
05 2021
Historique:
revised: 09 03 2021
received: 21 10 2020
accepted: 10 03 2021
pubmed: 17 3 2021
medline: 27 5 2021
entrez: 16 3 2021
Statut: ppublish

Résumé

Blood tests to monitor disease activity, attack severity, or treatment impact in neuromyelitis optica spectrum disorder (NMOSD) have not been developed. This study investigated the relationship between serum glial fibrillary acidic protein (sGFAP) concentration and NMOSD activity and assessed the impact of inebilizumab treatment. N-MOmentum was a prospective, multicenter, double-blind, placebo-controlled, randomized clinical trial in adults with NMOSD. sGFAP levels were measured by single-molecule arrays (SIMOA) in 1,260 serial and attack-related samples from 215 N-MOmentum participants (92% aquaporin 4-immunoglobulin G-seropositive) and in control samples (from healthy donors and patients with relapsing-remitting multiple sclerosis). At baseline, 62 participants (29%) exhibited high sGFAP concentrations (≥170 pg/ml; ≥2 standard deviations above healthy donor mean concentration) and were more likely to experience an adjudicated attack than participants with lower baseline concentrations (hazard ratio [95% confidence interval], 3.09 [1.6-6.1], p = 0.001). Median (interquartile range [IQR]) concentrations increased within 1 week of an attack (baseline: 168.4, IQR = 128.9-449.7 pg/ml; attack: 2,160.1, IQR = 302.7-9,455.0 pg/ml, p = 0.0015) and correlated with attack severity (median fold change from baseline [FC], minor attacks: 1.06, IQR = 0.9-7.4; major attacks: 34.32, IQR = 8.7-107.5, p = 0.023). This attack-related increase in sGFAP occurred primarily in placebo-treated participants (FC: 20.2, IQR = 4.4-98.3, p = 0.001) and was not observed in inebilizumab-treated participants (FC: 1.1, IQR = 0.8-24.6, p > 0.05). Five participants (28%) with elevated baseline sGFAP reported neurological symptoms leading to nonadjudicated attack assessments. Serum GFAP may serve as a biomarker of NMOSD activity, attack risk, and treatment effects. ANN NEUROL 2021;89:895-910.

Identifiants

pubmed: 33724534
doi: 10.1002/ana.26067
pmc: PMC8252046
doi:

Substances chimiques

Antibodies, Monoclonal, Humanized 0
Biomarkers 0
GFAP protein, human 0
Glial Fibrillary Acidic Protein 0
inebilizumab 74T7185BMM

Banques de données

ClinicalTrials.gov
['NCT02200770']

Types de publication

Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

895-910

Subventions

Organisme : NEI NIH HHS
ID : R01 EY022936
Pays : United States

Investigateurs

Kazuo Fujihara (K)
Friedemann Paul (F)
Hans-Peter Hartung (HP)
Romain Marignier (R)
Ho Jin Kim (HJ)
Brian G Weinshenker (BG)
Sean J Pittock (SJ)
Dean M Wingerchuk (DM)
Gary R Cutter (GR)
Ari J Green (AJ)
Maureen A Mealy (MA)
Jorn Drappa (J)

Informations de copyright

© 2021 The Authors. Annals of Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.

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Auteurs

Orhan Aktas (O)

Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.

Jeffrey L Bennett (JL)

School of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, CO.

Dewei She (D)

Viela Bio, Gaithersburg, MD.

Eliezer Katz (E)

Viela Bio, Gaithersburg, MD.

Bruce A C Cree (BAC)

Department of Neurology, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA.

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Classifications MeSH