Publications by authors named "Z L E van Kempen"
Importance: Increasing numbers of people with multiple sclerosis (MS) use disease-modifying therapy (DMT). Long-term stable disease while taking such medications provides a rationale for considering DMT discontinuation given patient burden, costs, and potential adverse effects of immunomodulating therapy.
Objective: To investigate whether first-line DMT can be safely discontinued in patients with long-term stable MS.
Background: Biomarkers of neuronal and axonal damage (serum neurofilament light (sNfL) and serum glial fibrillary acidic protein (sGFAP)) may provide insight into the aetiology of natalizumab wearing-off symptoms (WoSs).
Objectives: We investigated the longitudinal association between and predictive value of sNfL and sGFAP and the occurrence of WoS in MS patients treated with natalizumab.
Methods: We performed longitudinal measurements of sNfL and sGFAP in NEXT-MS trial participants who completed a questionnaire about WoS.
Article Synopsis
- Serum neurofilament light (sNfL) serves as a biomarker for neuro-axonal damage in multiple sclerosis (MS) but its clinical usage is still limited; this study assessed how its implementation affects clinical decisions at the MS Center Amsterdam.
- Over the study period (August 2021-December 2022), sNfL was evaluated in various contexts, with a notable change in clinical decisions in 19.3% of cases, especially when assessing new symptoms or when higher sNfL levels were present.
- The findings suggest that integrating sNfL into clinical practice improved decision-making certainty and potentially adjusted expectations regarding MRI activity, indicating its potential value in patient care while calling for further research
The recurrence of disease activity after ocrelizumab discontinuation in multiple sclerosis.
Mult Scler Relat Disord
November 2024
Introduction: Ocrelizumab (OCR) is a highly effective treatment of multiple sclerosis (MS), and B cell repopulation profiles suggest that it might be used as an immune reconstitution therapy. However, data on disease recurrence after stopping treatment with OCR are scarce. Our objective was to evaluate the recurrence of disease activity after OCR discontinuation.
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- Higher age is linked to decreased inflammatory activity in relapsing-remitting multiple sclerosis (RRMS), but it's unclear if this is due to age itself or disease duration.
- This study analyzed data from five large clinical trials to examine how age and disease duration impact relapse rates, MRI lesions, and other indicators of disease activity in RRMS.
- Results showed that older patients had significantly lower relapse rates and fewer lesions on MRI, regardless of how long they had the disease, suggesting that age factors should be considered in clinical trial designs and treatment predictions.