Reviewing the Utilization of Serum Biomarker Tests for Diagnosing Multiple Sclerosis: William Kilgo, MD

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“I think it's a new objective tool for therapeutic monitoring that goes beyond the MRI that’s more easily accessible in some cases for patients because it's a blood test. You don't necessarily have to pre-cert an MRI and wait 3 or 4 weeks to get it done, you can get it done right there in the clinic. It gives you additional information, besides the MRI information, you may not have been expecting to get about the patient's level of disease activity.”.

The conventional monitoring for multiple sclerosis (MS) in patients is conducted using a combination of both clinical and radiographic assessments. One of the tests, the Multiple Sclerosis Disease Activity (MSDA) test, is a multi-protein blood assessment with previous clinical validation relative to markers of disease activity.¹ The test measures 18 proteins to determine 4 disease pathway scores and an overall Disease Activity score scaled from 1.0-10.0 with thresholds corresponding to low, moderate, and high levels of disease activity.

In a recent retrospective review of academic MS clinics, researchers concluded that the MSDA test is a reliable indicator of objective disease activity in routine clinicals. The test was reviewed in 68 patient charts between September 2022 and February 2023.¹ Among those included, 72% had no evidence of recent disease activity by clinical or MRI metrics, 71% scored in the “Low” disease activity category, 18% scored in “Moderate,” and 12% scored in the “High.” Each of the 8 “High” scorers had either recent objective clinical disease activity and/or MRI activity and 2 of them had elevated MSDA scores prior to clinical or radiographic evidence of disease activity.

Lead author William Kilgo, MD, director of the neurology residency program and assistant professor of neurology at the University of South Alabama College of Medicine, presented the findings at the MSMilan 2023, the joint ECTRIMS-ACTRIMS meeting, held October 11–13, in Milan, Italy. At the meeting, Kilgo sat down with NeurologyLive® to provide a summary of the findings and their implications for clinicians. He talked about when the serum biomarker test is the most useful for patients with MS, according to his clinical experience as well as how the serum biomarker test correlates with MRI findings in identifying patients who are at an elevated risk of disease activity. Additionally, he discussed the potential benefits of using serum biomarker tests in a diverse MS patient population, and how it complements traditional monitoring with MRIs.

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REFERENCES
1. Kilgo W, Padarti A, Izbicki, P et al. Real-World Utilization of a Proteomic Biomarker Panel for Assessing Multiple Sclerosis Disease Activity in an Academic Multiple Sclerosis Clinic with a Diverse Patient Population. Presented at: 2023 MSMilan; October 11-12; Milan, Italy. Abstract P232.