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Articles by Simon Thebault
Pioneering a New Concept for Neurology and Multiple Sclerosis - Biosimilar Natalizumab: Interview with Two Key Opinion Leaders
The availability of disease-modifying treatments (DMT), including biologic medicines such as monoclonal antibodies, has transformed the treatment field for multiple sclerosis (MS). These high-efficacy therapies can bring substantial benefits to the lives of patients, but their high cost to healthcare systems can limit access. In response, an increasing number of more cost-effective biosimilar medicines have emerged as follow-on medicines after patent expiry of the original biologics.
Paediatric cerebrospinal fluid immune profiling distinguishes paediatric-onset multiple sclerosis from other paediatric-onset acute neurological disorders
Keywords Paediatric-onset multiple sclerosis Paediatric-onset MOGAD Paediatric cerebrospinal fluid Antibody-secreting cells Evidence before this study Immune cells involved in normal steady-state surveillance of the central nervous system (CNS) can be present within the cerebrospinal fluid (CSF). In neuroinflammatory disorders such as multiple sclerosis (MS), disease-associated immune cells infiltrate the CNS and can also be detected in the CSF.
Pediatric cerebrospinal fluid immune profiling distinguishes pediatric-onset multiple sclerosis from other pediatric-onset acute neurological disorders
Abstract The cerebrospinal fluid (CSF) provides a unique glimpse into the central nervous system (CNS) compartment and offers insights into immune processes associated with both healthy immune surveillance as well as inflammatory disorders of the CNS.
Emerging Cerebrospinal Fluid Biomarkers of Disease Activity and Progression in Multiple Sclerosis
Key Points Question What cerebrospinal fluid (CSF) measures are associated with relapsing vs nonrelapsing progressive multiple sclerosis (MS) disease biology? Findings This cohort study found that elevated glial fibrillary acid protein (GFAP) and neurofilament heavy chain were associated with nonrelapsing progression and lymphocyte measures were associated with relapsing biology in patients with both relapsing and primary progressive clinical phenotypes.
An Overview of Transcranial Magnetic Stimulation and Its Application in Multiple Sclerosis
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Severe Neuroinvasive West Nile Virus in Association With Anti-CD20 Monotherapy for Multiple Sclerosis
Discussion These are the first reported cases of neuroinvasive WNV infection in individuals (whether with MS or other conditions) on anti-CD20 monotherapy who are otherwise immunocompetent. While patients with lymphoma and patients with RA and SLE on additional concurrent immune therapy are known to be at risk of immune suppression, none of our patients had other compelling explanations for immunosuppression besides anti-CD20 therapy.
NfL is ready for translation into paediatrics
Diagnostic and therapeutic advancements for neurological conditions will be aided by progress in biomarker research across the age span.
CLIPPERS Responsive to Cladribine as a Durable Steroid-Sparing Agent
Abstract Objective We report a case of chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) who achieved durable and steroid-free remission after IV cladribine. Methods A 25 year-old man presented with progressively worsening headaches, polydipsia, dysarthria, diplopia and vertigo, and obtundation requiring respiratory support. CSF revealed lymphocytosis, and MRI revealed a perivascular pattern of punctate enhancement involving the pons.
High or increasing serum NfL is predictive of impending multiple sclerosis relapses
Highlights • In patients with active MS closely monitored over 1 year, higher baseline serum NfL (sNfL) levels were predictive of relapses (p=0.0068), new MRI gadolinium enhancing lesions (p=0.0096), composite confirmed disability worsening (cCDA, p=0.0072), composite relapse associated worsening (cRAW, p=0.01) and composite progression independent of relapse activity (cPIRA p=0.0096). Serum GFAP levels were weakly predicative of subsequent MRI lesions only (p=0.044).
Serum neurofilament light in MS: The first true blood-based biomarker?
Serum NfL as a biomarker in MS Neurofilaments are neuronal-specific heteropolymers assembled from five different intermediate filaments in different combinations and concentrations depending on the type of neuron, location in the axon and stage of development.7 In mature myelinated axons, neurofilaments are the single most abundant protein where their primary role is to support axonal structure.
Autologous hematopoietic stem cell transplantation for multiple sclerosis: A current perspective
1. Wallin, MT, Culpepper, WJ, Campbell, JD, et al. The prevalence of MS in the United States. Neurology 2019; 92: e1029–e1040. Google Scholar | Crossref | Medline 2. Giovannoni, G, Turner, B, Gnanapavan, S, et al. Is it time to target no evident disease activity (NEDA) in multiple sclerosis? Mult Scler Relat Disord 2015; 4(4): 329–333. Google Scholar | Crossref | Medline 3. Sormani, MP, Muraro, PA, Saccardi, R, et al.
Serum neurofilament light chain predicts long term clinical outcomes in multiple sclerosis
Abstract Serum neurofilament light chain (NfL) is emerging as an important biomarker in multiple sclerosis (MS). Our objective was to evaluate the prognostic value of serum NfL levels obtained close to the time of MS onset with long-term clinical outcomes. In this prospective cohort study, we identified patients with serum collected within 5 years of first MS symptom onset (baseline) with more than 15 years of routine clinical follow-up.
Neurotoxicity after hematopoietic stem cell transplant in multiple sclerosis
Introduction Immunoablation and autologous hematopoietic stem cell transplantation (IAHSCT) is an intensive yet efficacious therapy used for particularly aggressive cases of multiple sclerosis (MS).1 Specific regimes utilized by different centers vary mainly in both intensity of treatment conditioning and durable efficacy of treatment responses.2 The Canadian regimen3 is considered particularly intensive and involves high‐dose cyclophosphamide and busulfan as conditioning agents.
High serum neurofilament light chain normalizes after hematopoietic stem cell transplantation for MS
Abstract Objective To evaluate neurofilament light chain (NfL) levels in serum and CSF of patients with aggressive MS pre- and post-treatment with immunoablation followed by autologous hematopoietic stem cell transplantation (IAHSCT) and examine associations with clinical and MRI outcomes. Methods Paired serum and CSF in addition to MRI and clinical measures were collected on 23 patients with MS at baseline and 1 and 3 years post-IAHSCT.
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