A systematic review and meta-analysis of real-world data predictors for conversion to progressive multiple sclerosis
Solís-Tarazona, Luis Rafael ; Molina-Castaño, Maria ; Barea-Moya, Lucas ; Galan, Joana ; Raket, Lars Lau LU
and Gil-Perotin, Sara
(2025)
In Multiple Sclerosis and Related Disorders
103.
- Abstract
Background: Available fluid biomarkers, neuroimaging techniques, and clinical assessments may enhance prediction of conversion to secondary progressive multiple sclerosis (SPMS). Objectives: : To identify robust real-world predictors of MS progression in the literature. Methods: : A systematic review was conducted in EMBASE. A total of 20,338 MS patients from 64 eligible studies were included. A p-value meta-analysis and a tipping point analysis were performed to assess associations with MS progression and EDSS. Results: Among CSF biomarkers, GFAP (p = 6.2 × 10⁻¹⁰) and CHI3L1 (p = 1.7 × 10⁻¹¹) demonstrated consistent aggregated associations with disease progression. In serum, NfL (p = 2.5 × 10⁻13) and GFAP (p = 1.4 ×... (More)
Background: Available fluid biomarkers, neuroimaging techniques, and clinical assessments may enhance prediction of conversion to secondary progressive multiple sclerosis (SPMS). Objectives: : To identify robust real-world predictors of MS progression in the literature. Methods: : A systematic review was conducted in EMBASE. A total of 20,338 MS patients from 64 eligible studies were included. A p-value meta-analysis and a tipping point analysis were performed to assess associations with MS progression and EDSS. Results: Among CSF biomarkers, GFAP (p = 6.2 × 10⁻¹⁰) and CHI3L1 (p = 1.7 × 10⁻¹¹) demonstrated consistent aggregated associations with disease progression. In serum, NfL (p = 2.5 × 10⁻13) and GFAP (p = 1.4 × 10-8) showed strong association with concurrent EDSS and disease progression. Spinal cord lesions (p = 9.4 × 10⁻¹¹) and iron rim lesions (p = 4 × 10⁻⁶) were the strongest radiological predictors. Among clinical assessment tools, significant associations were found with concurrent EDSS, but prediction of progression was limited. Conclusion: Fluid biomarkers, particularly CSF GFAP, CHI3L1, and serum NfL, along with spinal cord lesions and iron rim lesions on MRI, provide consistent evidence for predicting MS progression. There is a need for harmonized and accessible outcome measures in real-world datasets.
(Less)
- author
- Solís-Tarazona, Luis Rafael
; Molina-Castaño, Maria
; Barea-Moya, Lucas
; Galan, Joana
; Raket, Lars Lau
LU
and Gil-Perotin, Sara
- organization
- publishing date
- 2025-11
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Accessibility, Biomarkers, Cerebrospinal fluid, Expanded Disability Status Scale, Multiple Sclerosis, Neuroimaging, Progression
- in
- Multiple Sclerosis and Related Disorders
- volume
- 103
- article number
- 106674
- publisher
- Elsevier
- external identifiers
-
- pmid:40840332
- scopus:105013649878
- ISSN
- 2211-0348
- DOI
- 10.1016/j.msard.2025.106674
- language
- English
- LU publication?
- yes
- id
- 2a89e894-afcd-4539-8129-f92ba14fbe2c
- date added to LUP
- 2025-10-09 12:21:58
- date last changed
- 2025-10-10 03:00:07
@article{2a89e894-afcd-4539-8129-f92ba14fbe2c,
abstract = {{<p>Background: Available fluid biomarkers, neuroimaging techniques, and clinical assessments may enhance prediction of conversion to secondary progressive multiple sclerosis (SPMS). Objectives: : To identify robust real-world predictors of MS progression in the literature. Methods: : A systematic review was conducted in EMBASE. A total of 20,338 MS patients from 64 eligible studies were included. A p-value meta-analysis and a tipping point analysis were performed to assess associations with MS progression and EDSS. Results: Among CSF biomarkers, GFAP (p = 6.2 × 10⁻¹⁰) and CHI3L1 (p = 1.7 × 10⁻¹¹) demonstrated consistent aggregated associations with disease progression. In serum, NfL (p = 2.5 × 10⁻<sup>13</sup>) and GFAP (p = 1.4 × 10<sup>-8</sup>) showed strong association with concurrent EDSS and disease progression. Spinal cord lesions (p = 9.4 × 10⁻¹¹) and iron rim lesions (p = 4 × 10⁻⁶) were the strongest radiological predictors. Among clinical assessment tools, significant associations were found with concurrent EDSS, but prediction of progression was limited. Conclusion: Fluid biomarkers, particularly CSF GFAP, CHI3L1, and serum NfL, along with spinal cord lesions and iron rim lesions on MRI, provide consistent evidence for predicting MS progression. There is a need for harmonized and accessible outcome measures in real-world datasets.</p>}},
author = {{Solís-Tarazona, Luis Rafael and Molina-Castaño, Maria and Barea-Moya, Lucas and Galan, Joana and Raket, Lars Lau and Gil-Perotin, Sara}},
issn = {{2211-0348}},
keywords = {{Accessibility; Biomarkers; Cerebrospinal fluid; Expanded Disability Status Scale; Multiple Sclerosis; Neuroimaging; Progression}},
language = {{eng}},
publisher = {{Elsevier}},
series = {{Multiple Sclerosis and Related Disorders}},
title = {{A systematic review and meta-analysis of real-world data predictors for conversion to progressive multiple sclerosis}},
url = {{http://dx.doi.org/10.1016/j.msard.2025.106674}},
doi = {{10.1016/j.msard.2025.106674}},
volume = {{103}},
year = {{2025}},
}