Evaluating the potential of sNfL as a biomarker in MS management in the UK: insights from SUNLIT survey

Current evidence supports the use of NfL as a biomarker for neuroaxonal damage in multiple sclerosis (MS), but translation from clinical trials to clinical practice is needed to guide optimal patient management. The SUNLIT survey, led by the Novartis medical science liaisons in collaboration with leading MS experts, aimed to assess the utility of sNfL as a biomarker for MS in routine clinical practice within UK. The survey included key questions to assess the clinician’s opinion and level of understanding of sNfL, experience with sNfL measurement, potential drivers and barriers to sNfL testing, identification of potential patient targets and potential impact of sNfL testing on the management of MS, and the role of guidelines for on the adoption of sNfL into clinical practice for MS management across the UK. A total of 86 clinicians (neurologists specialising in MS, n = 45; MS nurse practitioners, n = 41) from the UK participated in the survey. All HCPs responded to all the survey questions. The findings from the neurologist interviews were positive, supporting the use of sNfL if available (98%). Neurologists perceived that sNfL testing could be used at multiple points in the MS patient management pathway, commonly at treatment switch or initiation, and that it could potentially reduce frequency of MRI scans. The majority of clinicians demonstrated a moderate level of understanding regarding sNfL data in MS; with most clinicians perceiving a need for additional education, and low awareness of existing guidelines on sNfL testing in MS management. Access to sNfL testing and potential confounders like age and BMI were identified as potential barriers to its implementation. The SUNLIT survey provides important insights into the opinion of HCPs on the potential role of sNfL as a biomarker for MS in the UK. The high level of interest in sNfL testing, coupled with the identified barriers and need for additional education, highlights the need for concerted efforts to support the adoption of sNfL in clinical practice. By addressing these challenges, sNfL has the potential to significantly enhance the management of MS, providing clinicians with a valuable tool for monitoring disease activity and informing treatment decisions.