Peter Calabresi, MD

“If you have a really sophisticated immunology lab, it turns out you can pretty much reproduce the Quanterix data, but if you’re new or not paying attention to how the assay runs, there’s potential for a little bit more noise.”

In multiple sclerosis (MS), one of the biggest ongoing conversations surrounds the need for biomarkers of disease activity, specifically those which would allow for better determination of which disease-modifying therapy is best for a given patient. Right now, there are many who believe that biomarker could be neurofilament light.

Although that need is certainly valid, another concern is the development of a universal assay to measure the biomarker in question. For Peter Calabresi, MD, the director of the Johns Hopkins Multiple Sclerosis Center, the biomarker is perhaps only as useful as the clinician community’s ability to read out its measurements.

Additionally, the need for quick results that are easily reproducible has become apparent. This issue compounds when the only current options are so-called “homebrew” kits, which can work but can also lead to inconsistent results. Calabresi noted that Biogen and Siemens are working together toward widely developing a platform as sensitive as what’s available, but could also be uniform and global, in order to allow for identical interpretation. 

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For the director of the Johns Hopkins Multiple Sclerosis Center, a biomarker is perhaps only as useful as the clinician community’s ability to read out its measurements.

Peter Calabresi, MD: Utilizing A Uniform Biomarker Assay

“In MS, we know some people will end up in a wheelchair in 5 or 10 years, and other people can go 40 years and you wouldn’t know they had MS by looking at them walking across the street. When you’re dealing with a disease like that, that presents in the 20s and 30s, you would really benefit from some prognostic biomarker to say you’re having damage to your nervous system and need to go on aggressive therapy.”

At the 34th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Berlin, Germany, one of the highly debated topics was the use of the investigational biomarker, neurofilament light, in the clinic.

While the biomarker already has an easily available and reproducible assay, its use in clinical practice has yet to be validated. Although, for Peter Calabresi, MD, the director of the Johns Hopkins Multiple Sclerosis Center, it appears that it may be on its way toward validation. He and colleagues have assessed the biomarker and its presentation during the use of disease-modifying therapies, as well as to see how it correlates with other measures of disease activity. Thus far, it has shown positive results.

 on-site in Berlin to speak about the ongoing discussion and current knowledge about the use of neurofilament light, as well as his thoughts on its potential in the space.

Specifically, the professor of neurology at Johns Hopkins mentioned that its potential to provide prognostic information about damage to the central nervous system could be hugely beneficial to physicians treating patients with multiple sclerosis, as the disease is heterogenous, and can vary widely from patient to patient.

One of the highly debated topics at ECTRIMS 2018 was the use of the investigational biomarker, neurofilament light, in the clinic.

Author | Peter Calabresi, MD

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