dc.contributor
Institut Català de la Salut
dc.contributor
[Yaldizli Ö] Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland. Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Basel, Switzerland Neurologic Clinic and Policlinic, MS Centre, University Hospital Basel, Basel, Switzerland. Translational Imaging in Neurology Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel, University of Basel, Basel, Switzerland. [Benkert P] Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland. [Achtnichts L] Neurozentrum Oberaargau, Langenthal, Switzerland. [Bar-Or A] Center for Neuroinflammation and Experimental Therapeutics and Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. [Bohner-Lang V] Patient Consultant, Basel, Switzerland. [Bridel C] Translational Biomarker Research Group, Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland. [Comabella M, Tintore M, Tur C] Centre d’Esclerosi Múltiple de Catalunya (CEMCAT), Barcelona, Spain. Vall d’Hebron Hospital Universitari, Barcelona, Spain
dc.contributor
Vall d'Hebron Barcelona Hospital Campus
dc.contributor.author
Yaldizli, Özgür
dc.contributor.author
Benkert, Pascal
dc.contributor.author
Achtnichts, Lutz
dc.contributor.author
Bohner-Lang, Viviane
dc.contributor.author
Bridel, Claire
dc.contributor.author
Bar-Or, Amit
dc.contributor.author
Comabella Lopez, Manuel
dc.contributor.author
Tintore, Mar
dc.contributor.author
TUR, CARMEN
dc.date.accessioned
2025-10-24T10:41:36Z
dc.date.available
2025-10-24T10:41:36Z
dc.date.issued
2025-09-19T11:55:18Z
dc.date.issued
2025-09-19T11:55:18Z
dc.identifier
Yaldizli Ö, Benkert P, Achtnichts L, Bar-Or A, Bohner-Lang V, Bridel C, et al. Personalized treatment decision algorithms for the clinical application of serum neurofilament light chain in multiple sclerosis: A modified Delphi Study. Mult Scler J. 2025 Jul;31(8):932-43.
dc.identifier
http://hdl.handle.net/11351/13696
dc.identifier
10.1177/13524585251335466
dc.identifier
001478523200001
dc.identifier.uri
http://hdl.handle.net/11351/13696
dc.description.abstract
De-escalation; Personalized treatment strategies; Serum neurofilament light chain
dc.description.abstract
Desescalada; Estrategias de tratamiento personalizadas; Cadena ligera de neurofilamentos sérica
dc.description.abstract
Desescalada; Estratègies de tractament personalitzades; Cadena lleugera de neurofilaments sèrics
dc.description.abstract
Background: Serum neurofilament light (sNfL) chain levels, a sensitive measure of disease activity in multiple sclerosis (MS), are increasingly considered for individual therapy optimization yet without consensus on their use for clinical application.
Objective: We here propose treatment decision algorithms incorporating sNfL levels to adapt disease-modifying therapies (DMTs).
Methods: We conducted a modified Delphi study to reach consensus on algorithms using sNfL within typical clinical scenarios. sNfL levels were defined as "high" (>90th percentile) vs "normal" (<80th percentile), based on normative values of control persons. In three rounds, 10 international and 18 Swiss MS experts, and 3 patient consultants rated their agreement on treatment algorithms. Consensus thresholds were defined as moderate (50%-79%), broad (80%-94%), strong (≥95%), and full (100%).
Results: The Delphi provided 9 escalation algorithms (e.g. initiating treatment based on high sNfL), 11 horizontal switch (e.g. switching natalizumab to another high-efficacy DMT based on high sNfL), and 3 de-escalation (e.g. stopping DMT or extending intervals in B-cell depleting therapies).
Conclusion: The consensus reached on typical clinical scenarios provides the basis for using sNfL to inform treatment decisions in a randomized pragmatic trial, an important step to gather robust evidence for using sNfL to inform personalized treatment decisions in clinical practice.
dc.description.abstract
This study is part of the MultiSCRIPT trial supported by the Swiss National Science Foundation as part of the Investigator Initiated Clinical Trial program (grant no. 33IC30_205806/1).
dc.format
application/pdf
dc.publisher
SAGE Publications
dc.relation
Multiple Sclerosis Journal;31(8)
dc.relation
https://doi.org/10.1177/13524585251335466
dc.rights
Attribution 4.0 International
dc.rights
http://creativecommons.org/licenses/by/4.0/
dc.rights
info:eu-repo/semantics/openAccess
dc.subject
Esclerosi múltiple - Tractament
dc.subject
Medicina personalitzada
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Filaments citoplasmàtics
dc.subject
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Precision Medicine
dc.subject
CHEMICALS AND DRUGS::Amino Acids, Peptides, and Proteins::Proteins::Amino Acids, Peptides, and Proteins::Proteins::Nerve Tissue Proteins::Neurofilament Proteins
dc.subject
DISEASES::Nervous System Diseases::Autoimmune Diseases of the Nervous System::Demyelinating Autoimmune Diseases, CNS::Multiple Sclerosis
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Other subheadings::Other subheadings::Other subheadings::/drug therapy
dc.subject
INFORMATION SCIENCE::Information Science::Systems Analysis::Delphi Technique
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TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::medicina de precisión
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COMPUESTOS QUÍMICOS Y DROGAS::aminoácidos, péptidos y proteínas::proteínas::aminoácidos, péptidos y proteínas::proteínas::proteínas del tejido nervioso::proteínas de neurofilamentos
dc.subject
ENFERMEDADES::enfermedades del sistema nervioso::enfermedades autoinmunitarias del sistema nervioso::enfermedades autoinmunes desmielinizantes del SNC::esclerosis múltiple
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Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia
dc.subject
CIENCIA DE LA INFORMACIÓN::Ciencias de la información::análisis de sistemas::técnica Delfos
dc.title
Personalized treatment decision algorithms for the clinical application of serum neurofilament light chain in multiple sclerosis: A modified Delphi Study
dc.type
info:eu-repo/semantics/article
dc.type
info:eu-repo/semantics/publishedVersion
