Serum Glial Fibrillary Acidic Protein as Biomarker for MS Progression

Serum glial fibrillary acidic protein (sGFAP) concentrations are a prognostic biomarker for disability progression independent of relapse activity (PIRA) in multiple sclerosis (MS) and should be considered alongside neurofilament light chain (sNfL) levels, according to new research published in JAMA Neurology. Every time baseline sGFAP levels doubled, it was associated with a loss of gray matter volume (−0.24% per year; 95% CI, −0.35% to −0.12%; P<.001). When both sGFAP and sNfL levels were elevated, the researchers noted a 4- to 5-fold increased risk of confirmed disability worsening (hazard ratio [HR], 4.09; 95% CI, 2.04-8.18; P<.001) and PIRA (HR, 4.71; 95% CI, 2.05-9.77; P<.001).

The longitudinal, prospective, multicenter study took place in Switzerland from January 1, 2012 to October 20, 2022 and compared sNfL and sGFAP levels from blood tests in participants with stable MS and worsening progressive MS (n=355) with blood samples from healthy controls (n=259). The first cohort included untreated participants who had MS and a worsening or stable disability and similar Expanded Disability Status Scale scores at baseline with no relapses during follow-up.  In the second cohort, participants were those who were completing B cell-depleting treatment.

According to researchers: “sGFAP is more strongly associated than sNfL with disease progression in MS, a finding that has clinical implications for patient management and development of novel drugs.”