an mri which had fallen off the radar is back on track.
i was researching cladribine this morning in prep. found a note on its ability to lower neurofilament light chain, but it was only a couple of case reports.
went to refresh on what if anything vit d3 can do in the neurofilament light chain department.
looks like per one study (1st below) that serum vit d3 levels above 100 nmol/l are most likely to maintain normal neurofilament light chain levels
also per another study (2nd below) that treatment with 20K IU d3 per week did not improve neurofilament light chain levels when in combination with a DMT
improvements to NFLC status seen via d3 alone, without a DMT, did not achieve statistical significance. (i note that the d3 only group got the lowest mean NFLC levels overall at week 96 but also had a lower mean starting NFLC in comparison to any placebo group, so one way or another the change was not dramatic enough to pull off significance).
only 28/35 participants in the 20K IU/wk d3 treatment group achieved levels at or above 100 nmol/l (ie in study 2 below, 20% did not achieve the d3 levels associated with best NFLC effect per study one below).
so, this only looks at one piece of a complex puzzle but since my last serum d3 test came back at 166 nmol/l, i'm not in any rush to try cladribine just on the off-chance it may help with a possibly non-existent elevated neurofilament light chain problem.
- Disease activity in progressive multiple sclerosis can be effectively reduced by cladribine (2018)
https://www.msard-journal.com/article/S ... 0/abstract
We report on two pwPMS, who were treated with subcutaneous cladribine undergoing CSF NfL testing, alongside MRI and clinical follow-up, before and after treatment.
Cladribine treatment was well tolerated without any side effects. CSF NfL after treatment revealed significant reduction (by 73% and 80%, respectively) corroborating the MRI detectable drop in disease activity. Disability mildly progressed in one, and remained stable in the other pwPMS.
- Vitamin D and axonal injury in multiple sclerosis (2015)
https://journals.sagepub.com/doi/abs/10 ... 8515606986
There was an inverse association between serum 25(OH)D and CSF-NFL levels in categorical (dichotomized at 75 or 100 nmol/l) analyses. A dose-response effect for 25(OH)D levels on CSF-NFL levels (p for trend=0.034) was also present. Serum 25(OH)D levels above 100 nmol/l were associated with lower CSF-NFL levels independently of ongoing MS treatment.
High 25(OH)D levels are associated with decreased axonal injury in MS.
- Vitamin D supplementation and neurofilament light chain in multiple sclerosis (2019)
https://onlinelibrary.wiley.com/doi/abs ... /ane.13037
Serum levels of 25‐hydroxyvitamin D more than doubled in the vitamin D group. Compared to placebo, vitamin D supplementation had no overall effect on the change in serum levels of NFL from baseline (P = 0.93 at week 48 and P = 0.56 at week 96). In the subgroup of patients not receiving disease‐modifying therapy, NFL decreased by 30.9% to week 48% and 32.6% to week 96 from baseline in the vitamin D group as compared to the placebo group (P = 0.06 for both time points).
With a possible exception for patients not treated with disease‐modifying drugs, weekly supplementation with 20 000 IU vitamin D3 did not affect NFL levels in these RRMS patients.
There was a negative correlation between NFL and body mass index (r = 0.30, P = 0.01), and an unexpected positive correlation with 25‐hydroxyvitamin D (r = 0.25, P = 0.04). As previously reported, the mean serum concentration of 25‐ hydroxyvitamin D was more than doubled in the vitamin D group and was 123.2 nmol/L at week 96. There was also a minor increase from 57.3 nmol/L to 61.8 nmol/L in the placebo group. At week 96 25‐hydroxyvitamin D levels were above 100 nmol/L in 28/35 of the patients in the vitamin D group and 2/33 in the placebo group. ...