Oligoclonal IgM Bands in Relapsing MS: A Potential Biomarker of Long-Term Disability?

The presence of oligoclonal immunoglobulin M (IgM) bands (OCMBs) among patients with relapsing multiple sclerosis (MS) may serve as a biomarker for long-term, MS-related disability, according to new findings published in Multiple Sclerosis Journal.

These findings emerged from a study of 89 patients with relapsing MS (71 women; median age 32.9 years) at the Hospital Clinic of Barcelona. Median follow-up lasted 9.6 years. The researchers recorded data on the following factors from patients with cerebrospinal fluid (CSF) samples collected 2 years or fewer after the onset of MS:

• Demographics
• IgM index
• OCMBs
• Lipid-specific OCMBs
• Levels of CSF neurofilament light chain protein
• Expanded Disability Status Scale (EDSS) scores
• Relapses and use of disease-modifying therapies throughout the study period
• Peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell plus inner plexiform layer (GCIPL) thicknesses among patients without optic neuritis at the end of follow-up

Multivariable models were used to examine associations between CSF markers and MS outcomes. The results of the study indicated that OCMBs in particular were associated with a 33% higher annual relapse rate, higher likelihood of using high-efficacy disease-modifying therapies (odds ratio [OR] 4.8), thinner GCIPL and pRNFL (β −2.9 and −4.4, respectively), and higher likelihood of EDSS scores of at least 3.0 (hazard ratio [HR] 4.4) and at least 4.0 (HR 5.4).

The researchers noted that they did not observe any overall associations for other CSF markers. “The presence of OCMB was associated with unfavorable long-term outcomes. OCMB should be determined in [relapsing MS] to inform long-term prognosis,” the researchers concluded.

—Christina Vogt

Reference:
Capuano R, Zubizarreta I, Alba-Arbalat S, et al. Oligoclonal IgM bands in the cerebrospinal fluid of patients with relapsing MS to inform long-term MS disability. Mult Scler J. Published online January 12, 2021. doi:10.1177/1352458520981910