“Right now, the medical community doesn’t know if MS treatment can be safely stopped. Our hope is that blood tests could one day help make decisions on when to stop or restart treatment.”- Dr. Gauruv BoseA study led by Dr. Gauruv Bose suggests that a blood test may be able to predict which individuals are at greatest risk of multiple sclerosis (MS) symptoms returning after they stop treatment. Some people prefer to stop immune-suppressing treatment if their disease has been stable for years, but there’s no way to know whether their symptoms will return. 

This observational study published in Neurology & Neuroinflammation followed 78 people with clinically stable MS who had stopped treatment, examining them every six months for up to 14 years. The team looked at levels of sNfL and sGFAP in the blood within one year before treatment was stopped, and again within a year after treatment was stopped. These molecules are released when nerves are damaged by inflammation and indicate MS activity. 

The team found that individuals whose levels of sNfL doubled after stopping treatment had four times the risk of MS symptoms returning years later. If their sGFAP levels increased by half, they had five times the risk of symptoms returning. Future studies will need to validate these findings and test whether restarting treatment after these molecule levels increase can keep symptoms from coming back.

“Right now, the medical community doesn’t know if MS treatment can be safely stopped. Our hope is that blood tests could one day help make decisions on when to stop or restart treatment,” said Dr. Gauruv Bose neurologist and associated scientist at The Ottawa Hospital, assistant professor at the University of Ottawa.

Authors: Gauruv Bose, Brian C. Healy, Shrishti Saxena, Fermisk Saleh, Bonnie I. Glanz , Rohit Bakshi, Howard L. Weiner, Tanuja Chitnis.

Data source: The Comprehensive Longitudinal Investigation of MS at the Brigham and Women's Hospital (CLIMB, climbstudy.org).

Funders: MS Canada, the United States Department of Defense

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