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Peer-reviewedCC BY 4.0Frontiers in Neurology

Not every patient with an initial clinical demyelinating event needs to be treated: a low CXCL13 index at the time of the ICDE has prognostic value for the absence of later activity

  • Andrew R. Pachner1,2
  • Steven C. Pike1,2
  • Francesca Gilli1,2
  1. 1Dartmouth College
  2. 2Dartmouth-Hitchcock Medical Center
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Abstract

The management of persons with an initial clinical demyelinating event (PwICDE) is controversial. Frequently, patients with ICDE are often treated with an Multiple Sclerosis (MS) disease-modifying therapy (DMT), while in others, a “wait-and-see” approach is followed. Even in PwICDE who are prescribed a DMT, there are significant barriers to initiation of therapy. A reliable biomarker that can predict when it is safe to monitor patients rather than start a DMT would be highly beneficial. The CXCL13 index (I CXCL13 ), which measures the intrathecal production of CXCL13, a key chemokine for trafficking B cells and follicular helper T(Tfh) cells, is such a biomarker. In this study, low I CXCL13 is shown to predict the safety of remaining off DMTs.

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Cite

BibTeXRIS
BibTeX
@article{pachner2026every,
  title = {{Not every patient with an initial clinical demyelinating event needs to be treated: a low CXCL13 index at the time of the ICDE has prognostic value for the absence of later activity}},
  author = {Andrew R. Pachner and Steven C. Pike and Francesca Gilli},
  journal = {Frontiers in Neurology},
  year = {2026},
  month = nov,
  doi = {10.3389/fneur.2026.1823278},
  url = {https://www.frontiersin.org/articles/10.3389/fneur.2026.1823278/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Not every patient with an initial clinical demyelinating event needs to be treated: a low CXCL13 index at the time of the ICDE has prognostic value for the absence of later activity
AU  - Andrew R. Pachner
AU  - Steven C. Pike
AU  - Francesca Gilli
PY  - 2026
DA  - 2026/11/05
JO  - Frontiers in Neurology
DO  - 10.3389/fneur.2026.1823278
UR  - https://www.frontiersin.org/articles/10.3389/fneur.2026.1823278/full
AB  - The management of persons with an initial clinical demyelinating event (PwICDE) is controversial. Frequently, patients with ICDE are often treated with an Multiple Sclerosis (MS) disease-modifying therapy (DMT), while in others, a “wait-and-see” approach is followed. Even in PwICDE who are prescribed a DMT, there are significant barriers to initiation of therapy. A reliable biomarker that can predict when it is safe to monitor patients rather than start a DMT would be highly beneficial. The CXCL13 index (I CXCL13 ), which measures the intrathecal production of CXCL13, a key chemokine for trafficking B cells and follicular helper T(Tfh) cells, is such a biomarker. In this study, low I CXCL13 is shown to predict the safety of remaining off DMTs.
SN  - 1664-2295
ER  -