NMOSD Associated With Escalation to Rituximab, Elecsys NfL Test Receives European Approval, Neurology by the Numbers

WATCH TIME: 5 minutes | Captions are auto-generated and may contain errors.

Below is a transcript of the video.

Welcome to the Neurology News Network. My name is Louie Pasculli. Here’s a look at this week’s top stories in neurology.

A recent retrospective cohort study showed that severe baseline disability was strongly associated with subsequent treatment escalation to rituximab from azathioprine or mycophenolate mofetil in Thai patients with aquaporin-4 immunoglobulin G (AQP4-IgG)-positive neuromyelitis optica spectrum disorder (NMOSD). These findings suggest that earlier identification of high-risk patients may facilitate more individualized treatment approaches and may help inform policy decisions in resource-limited health care settings.^1,2

Among 173 patients (escalation group, n = 35; nonescalation group, n = 138) included in the study, baseline disability differed between groups. Although median Expanded Disability Status Scale (EDSS) scores prior to initiation of first-line therapy were similar, patients who later required treatment escalation had a greater burden of baseline disability compared with those who did not (median EDSS, 4 [4–6] vs 4 [3–5]; P = .022). Additionally, severe baseline disability was more frequently observed among patients who underwent escalation to rituximab (45.7% vs 24.6%; P = .014).

“In Thai patients with AQP4-IgG–positive NMOSD managed under an escalation-based treatment paradigm, baseline severe disability (EDSS ≥6) was the strongest clinical factor associated with subsequent escalation to rituximab. This finding underscores the value of early and systematic functional assessment in identifying patients at higher risk of inadequate disease control with conventional immunosuppressive therapy,” senior author Saharat Aungsumart, PhD, MD, neurologist at the Neurological Institute of Thailand, and colleagues wrote.¹

In a new company update, Roche has announced that its Elecsys neurofilament light chain (NfL) test has received CE mark approval for detecting neuroinflammation in patients with relapsing-remitting multiple sclerosis (RRMS). The company noted that the blood-based assay is designed to provide clinicians with a less invasive method to monitor disease-related nerve cell injury and support clinical decision-making.³

Previously granted breakthrough device designation by the FDA, the Elecsys NfL test measures NfL, a protein released into the bloodstream during neuroaxonal damage.2 By quantifying this biomarker through a simple blood draw, the test offers insight into the biological processes underlying neuroinflammation in MS. According to the company, this approach may complement existing tools such as MRI and clinical assessments by providing additional data on disease activity.

“This approval marks a transformative step forward in how we support adults with relapsing-remitting multiple sclerosis (RRMS),” Matt Sause, CEO at Roche Diagnostics, said in a statement. “The availability of a simple blood-based test has the potential to complement resource-intensive MRI scans and improve access for patients with RRMS. The Elecsys NfL test will help healthcare providers support timely clinical reassessment, enabling better disease management and more personalised care for patients.”³

In recognition of National Public Health Week, observed April 6-12, NeurologyLive® has developed a data-driven slideshow, Neurology by the Numbers, to spotlight the growing burden of neurologic disease across the United States and globally. Neurological conditions are now the leading cause of disability worldwide, affecting billions and placing increasing strain on health systems, clinicians, and caregivers. As populations age and diagnostic capabilities improve, the prevalence and impact of these disorders continue to rise, reinforcing the need for awareness, early detection, and access to specialized care.

This slideshow compiles key statistics across neurologic conditions including migraine, stroke, Alzheimer disease, epilepsy, and Parkinson disease, along with workforce data highlighting gaps in neurologist access. Each slide offers a concise snapshot of disease burden, helping clinicians better understand both the scale and nuance of these conditions. Together, these data points contextualize the broader public health challenge and encourage readers to explore neurology’s impact across patient populations.

To read the full piece and to get more direct access to expert insight, head to NeurologyLive.com. Be sure to tune in next week to remain informed on the latest in neurology. I’m Louie Pasculli, thanks for watching Neurology News Network.

REFERENCES
1. Siripornmongkol C, Apiwattanakul M, Aungsumart S. Baseline severe disability as a predictor of treatment escalation to rituximab in AQP4-IgG-positive NMOSD patients: A retrospective cohort study. Mult Scler Relat Disord. 2026;107:107022. doi:10.1016/j.msard.2026.107022
2. Silva GD, Apóstolos-Pereira SL, Boaventura M, et al. Early rituximab versus escalating therapy in neuromyelitis optica: A cost and quality of life analysis. Mult Scler Relat Disord. 2024;92:106160. doi:10.1016/j.msard.2024.106160
3. Roche receives CE mark for new Elecsys NfL blood test to detect neuroinflammation in multiple sclerosis. News release. Roche. April 12, 2026. Accessed April 13, 2026. https://www.roche.com/media/releases/med-cor-2026-04-13