{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:48:13Z","timestamp":1789670893720,"version":"4.0.1"},"reference-count":27,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) are associated with multiple sclerosis (MS) outcomes. We compare how high-efficacy early therapy (HEET) and lower-efficacy early therapy (LEET) affect serum NfL and GFAP at the initiation of disease-modifying therapy (DMT) and in the years afterwards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Adults diagnosed with MS within 5 years of symptom onset at our centre were eligible. Records from DMT-na\u00efve patients with serum NfL and GFAP drawn in the year before treatment start and follow-up samples 6\u201336 months after treatment initiation were included in the \u2018pre-initiation\u2019 cohort. Those with baselines after DMT initiation and follow-up samples within 5 years were included in the \u2018post-initiation\u2019 cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were 155 pre-initiation patients (HEET: 85, LEET: 70) and 213 post-initiation (HEET: 55, LEET: 158). NfL levels were reduced following DMT initiation but did not differ significantly between HEET and LEET in either cohort. GFAP was not substantially impacted by either HEET or LEET.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The difference in NfL reduction with HEET and LEET may be smaller than anticipated, perhaps reflecting that disease activity risk is considered in real-world DMT selection. There is minimal impact of HEET or LEET on GFAP, at least over several years.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585251335521","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T07:00:12Z","timestamp":1745823612000},"page":"944-954","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Change in serum neurofilament light chain and glial fibrillary acidic protein levels with high-efficacy and low-efficacy early therapy in multiple sclerosis"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5482-1949","authenticated-orcid":false,"given":"Evan","family":"Madill","sequence":"first","affiliation":[{"name":"Department of Neurology, Brigham Multiple Sclerosis Center, Brigham and Women\u2019s Hospital, Boston, MA, USA"},{"name":"Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Moreira Ferreira","sequence":"additional","affiliation":[{"name":"Department of Neurology, Brigham Multiple Sclerosis Center, Brigham and Women\u2019s Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5272-2425","authenticated-orcid":false,"given":"Brian","family":"Healy","sequence":"additional","affiliation":[{"name":"Department of Neurology, Brigham Multiple Sclerosis Center, Brigham and Women\u2019s Hospital, Boston, MA, USA"},{"name":"Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2896-8369","authenticated-orcid":false,"given":"Jonathan","family":"Zurawski","sequence":"additional","affiliation":[{"name":"Department of Neurology, Brigham Multiple Sclerosis Center, Brigham and Women\u2019s Hospital, Boston, MA, USA"},{"name":"Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariann","family":"Polgar-Turcsanyi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Brigham Multiple Sclerosis Center, Brigham and Women\u2019s Hospital, Boston, MA, USA"},{"name":"Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard L","family":"Weiner","sequence":"additional","affiliation":[{"name":"Department of Neurology, Brigham Multiple Sclerosis Center, Brigham and Women\u2019s Hospital, Boston, MA, USA"},{"name":"Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9897-4422","authenticated-orcid":false,"given":"Tanuja","family":"Chitnis","sequence":"additional","affiliation":[{"name":"Department of Neurology, Brigham Multiple Sclerosis Center, Brigham and Women\u2019s Hospital, Boston, MA, USA"},{"name":"Harvard 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Treatment-associated changes in serum glial fibrillary acidic protein and neurofilament light chain levels and risk of disability progression independent of relapse activity in multiple sclerosis. 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