Blood marker can identify risk of silent disability progression in MS

The levels of a protein called glial fibrillary acidic protein (GFAP) in the blood of people with multiple sclerosis (MS) can help to predict disability that happens in the absence of relapses – often called silent progression, according to a new study.

Relapses are often the main driver of MS disability, but for those who experience worsening disability without them, there are no clinical biomarkers that can predict it.

Researchers found that levels of neurofilament light chain protein (NfL), a protein from nerve cells that’s a well-established marker of a relapse, went up by 53.2% during relapses, but GFAP levels changed less than 5%. But in those with silent progression, GFAP were 57.5% higher and NfL only 28% higher.

NfL levels also were significantly associated with silent progression in people who were being treated with Ocrevus.

The researchers said the results support GFAP being a useful biomarker for predicting progression independent of relapse activity risk, and back up previous research identifying NfL as a marker of relapse activity.

They said more research is needed, in particular a need to assess whether GFAP can predict PIRA in MS patients on other therapies.