What are the different treatment options for MS?

Question

Hello doctor,

I recently received some test results. My neurofilament light chain levels are elevated at 45 pg/mL, my GFAP (glial fibrillary acidic protein) levels are also high, and MOG (myelin oligodendrocyte glycoprotein) antibodies were detected. I’m currently being treated with Rituximab.

Do these results indicate ongoing inflammation?
Should we consider adjusting my treatment plan?
What could these biomarkers mean for my long-term prognosis?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Thanks for reaching out, and I understand your concerns completely.

Elevated levels of neurofilament light chain, GFAP (glial fibrillary acidic protein), and MOG (myelin oligodendrocyte glycoprotein) antibodies may suggest ongoing neurological inflammation. These markers are often associated with active or relapsing forms of multiple sclerosis (MS) or other demyelinating conditions.

You're currently on Rituximab; it would be a good idea to speak with your neurologist about whether a change in treatment is needed. There are different treatment options for MS, including:

Corticosteroids are used to help reduce acute inflammation during flare-ups.
Disease-modifying therapies (DMTs) are for relapsing MS, such as:
- Lemtrada (Alemtuzumab).
- Tysabri (Natalizumab).
- Kesimpta (Ofatumumab).
- Mavenclad (Cladribine).
Ocrevus (Ocrelizumab) is used explicitly in progressive forms of MS to help reduce relapses and slow disease progression.
Ublituximab is an IV (intravenous) treatment that targets B cells and can help manage relapsing MS.
Plasma exchange (plasmapheresis) is sometimes used in severe relapses that don’t respond well to steroids.

Lifestyle modifications can also support your overall health and may help prolong remission. These include:

Avoiding smoking.
Getting enough sleep.
Maintaining a balanced diet rich in vitamin B12 (found in shellfish, crabs, meat, and fortified cereals)

This information helps clarify your concerns. If you have more questions, feel free to reach out.

Thank you.