THURSDAY, Feb. 27, 2025 (HealthDay News) — Four immunoassays for neurofilament light chain (NfL) demonstrate consistent performance in patients with amyotrophic lateral sclerosis (ALS), with high diagnostic and prognostic accuracy, according to a study published online Feb. 26 in Neurology.
Etienne Mondesert, from University Montpellier in France, and colleagues conducted a head-to-head comparison of four different technologies and three serum analytes to assess diagnostic and prognostic performance of NfL, glial fibrillary acidic protein (GFAP), and phosphorylated tau 181 (pTau181) biomarkers in ALS. NfL was assessed using the ultrasensitive Simoa and microfluidic Ella platforms and with Lumipulse and Elecsys assays, recently set up on clinical-grade platforms. Serum GFAP and pTau181 were also assessed using Elecsys.
The cohort included 139 patients with ALS and 70 patients without ALS. The researchers identified high correlation between all methods used for quantifying serum NfL (R2 = 0.939 to 0.963). For ALS diagnosis, the area under the curve (AUC) was 0.889, 0.906, 0.912, and 0.910 for NfL Simoa, Ella, Lumipulse, and Elecsys, respectively. Poor diagnostic performance was seen for serum pTau181 and GFAP (AUCs, 0.565 and 0.546, respectively). Significant hazard ratios were seen for blood NfL in a Kaplan-Meier survival analysis (hazard ratios, 4.4 to 5.4). Patients with ALS with values below the prognostic cutoff had a 40 to 50 percent chance of surviving 50 weeks, while the survival rates dropped to near zero with values above the prognostic cutoff.
“These tests can be useful in confirming a diagnosis in rare cases where it is uncertain,” the authors write. “Ultimately, the prognostic information they provide is certainly the most valuable aspect.”
Two authors disclosed ties to the biotechnology industry.
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