Astrocytic and Axonal Injury Biomarkers in AQP4 Antibody-Positive NMOSD: Insights From PREVENT and CHAMPION-NMOSD.

What was studied

This study measured 2 blood markers of injury in NMOSD with AQP4 antibodies. The markers are GFAP, for astrocyte injury, and NfL, for axon injury. The samples came from the PREVENT and CHAMPION-NMOSD phase 3 trials. People took eculizumab or ravulizumab. Both block complement component 5. Levels were compared with healthy donors. There were 41 patients from PREVENT and 55 from CHAMPION-NMOSD.

What they found

Before treatment, both markers were higher in patients than in healthy donors. High GFAP was linked to older age at presentation. It also went with a shorter gap since the last relapse. It went with a higher Hauser Ambulation Index score too. High NfL went with older age and a higher score. GFAP fell within 4-6 weeks with both drugs and stayed down. NfL fell significantly with ravulizumab, but not with eculizumab. In PREVENT, relapses went with higher GFAP in placebo patients. That rise was dampened with eculizumab.

What it means for patients

The authors say GFAP and NfL are raised in NMOSD. They say both tie to signs of disability. They say blocking complement component 5 suppresses astrocyte injury. They call GFAP a marker of drug action in phase 3 trials.

Why it is not certain yet

PREVENT samples were studied after the fact. CHAMPION-NMOSD samples were studied as planned. The 2 drugs were studied in different trials. So they were not compared head to head. The abstract gives samples from 41 and 55 patients.

Source

Astrocytic and Axonal Injury Biomarkers in AQP4 Antibody-Positive NMOSD: Insights From PREVENT and CHAMPION-NMOSD.

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