{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T19:42:27Z","timestamp":1782934947955,"version":"3.54.5"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T00:00:00Z","timestamp":1714694400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>The predictive value of serum neurofilament light chain (sNfL) and serum glial fibrillary acidic protein (sGFAP) for apheresis outcome in steroid\u2010refractory multiple sclerosis (MS) relapse has not yet been evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used pre\u2010 and postapheresis serum samples from 38 participants of the IAPEMS trial (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>: NCT02671682), which investigated the use of immunoadsorption versus plasma exchange for the treatment of steroid\u2010refractory MS attacks. Response to apheresis was classified based on improvement on (i) the Expanded Disability Status Scale (EDSS), (ii) the affected functional system scores (FSS) of the EDSS, or (iii) the visual acuity for patients with optic neuritis, 4\u2009weeks postapheresis. sNFL and sGFAP were measured by single molecule arrays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Preprocedural sGFAP levels could discriminate between responders and nonresponders, determined by FSS improvement (<jats:italic>p<\/jats:italic>\u2009=\u20090.017). In multivariate logistic regression analysis, younger age (odds ratio [OR] =\u20090.781, 95% confidence interval [CI] =\u20090.635\u20130.962, <jats:italic>p<\/jats:italic>\u2009=\u20090.020) and lower sGFAP levels (OR\u2009=\u20090.948, 95% CI\u2009=\u20090.903\u20130.995, <jats:italic>p<\/jats:italic>\u2009=\u20090.031) could predict response to apheresis in the overall cohort. We could observe a trend towards a favourable apheresis outcome with higher sNfL levels (OR\u2009=\u20091.413, 95% CI\u2009=\u20090.965\u20132.069, <jats:italic>p<\/jats:italic>\u2009=\u20090.076). Analysis of the sNfL\u2010to\u2010sGFAP ratio showed an OR of 1.924 (95% CI\u2009=\u20091.073\u20133.451, <jats:italic>p<\/jats:italic>\u2009=\u20090.028) for predicting apheresis response. The ratio showed a better predictive value than the individual parameters. Neither biomarker was affected by the number of steroid cycles preapheresis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lower sGFAP levels, a higher sNfL\u2010to\u2010sGFAP ratio, and younger age are associated with a favourable apheresis outcome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16323","type":"journal-article","created":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T12:58:59Z","timestamp":1714741139000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Serum neurofilament light chain and glial fibrillary acidic protein for predicting response to apheresis in steroid\u2010refractory multiple sclerosis relapses"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5443-1142","authenticated-orcid":false,"given":"Ioannis","family":"Vardakas","sequence":"first","affiliation":[{"name":"Department of Neurology University of Ulm  Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6352-0909","authenticated-orcid":false,"given":"Johannes","family":"Dorst","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Ulm  Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Huss","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Ulm  Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Mayer","sequence":"additional","affiliation":[{"name":"Institute for Epidemiology and Medical Biometry University of Ulm  Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Fangerau","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Ulm  Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9165-4437","authenticated-orcid":false,"given":"Daniela","family":"Taranu","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Ulm  Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayrettin","family":"Tumani","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Ulm  Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makbule","family":"Senel","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Ulm  Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30481-1"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/20552173211015503"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000653"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awac016"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2019.04.017"},{"key":"e_1_2_10_7_1","unstructured":"HemmerBet\u00a0al.Diagnose und Therapie der Multiplen Sklerose Neuromyelitis\u2010Optica\u2010Spektrum\u2010Erkrankungen und MOG\u2010IgG\u2010Assoziierten Erkrankungen S2k\u2010Leitlinie 2023.Deutsche Gesellschaft f\u00fcr Neurologie Leitlinien f\u00fcr Diagnostik und Therapie in der Neurologie. 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