Despite the potential of serum neurofilament light chain (sNfL) as a biomarker for assessing disease progression and treatment response in multiple sclerosis (MS), its routine clinical use remains limited. According to a recent study conducted in collaboration with the Spanish Society of Neurology (SEN), the underutilization of sNfl in MS care is largely due to therapeutic inertia (TI), or the failure to initiate or escalate treatment in cases where sNfL levels are elevated.

The study included 116 neurologists (78 were specialists in the care of demyelinating disorders) who assessed 9 simulated MS cases, including initial and relapsing-remitting MS cases. Results showed that 92.2% of participants exhibited TI in at least 2 of the 9 scenarios. Factors contributing to TI included a lack of specialization in MS care (P=.014), risk aversion (P=.008), and reluctance to adopt new evidence-based practices (P=.009).

Researchers noted that understanding the factors associated with TI could lead to targeted education about sNfl testing, which may result in its broader adoption in the management of individuals with MS.

Source: Saposnik G, Monreal E, Medrano N, et al. Does serum neurofilament light chain measurement influence therapeutic decisions in multiple sclerosis? Mult Scler Relat Disord. 2024;90:105838. doi:10.1016/j.msard.2024.105838