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Neurofilament results for the phase II neuroprotection study of phenytoin in optic neuritis.

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Title: Neurofilament results for the phase II neuroprotection study of phenytoin in optic neuritis.
Authors: Raftopoulos, R. (AUTHOR), Kuhle, J. (AUTHOR), Grant, D. (AUTHOR), Hickman, S. J. (AUTHOR), Altmann, D. R. (AUTHOR), Leppert, D. (AUTHOR), Blennow, K. (AUTHOR), Zetterberg, H. (AUTHOR), Kapoor, R. (AUTHOR), Giovannoni, G. (AUTHOR), Gnanapavan, S. (AUTHOR)
Source: European Journal of Neurology. Feb2021, Vol. 28 Issue 2, p587-594. 8p.
Subjects: Optic neuritis, Cytoplasmic filaments, Phenytoin, Visual pathways, Nerve fibers
Abstract: Background: A randomized trial of phenytoin in acute optic neuritis (ON) demonstrated a 30% reduction in retinal nerve fiber layer (RNFL) loss with phenytoin versus placebo. Here we present the corresponding serum neurofilament analyses. Methods: Eighty‐six acute ON cases were randomized to receive phenytoin (4–6 mg/kg/day) or placebo for 3 months, and followed up for 6 months. Serum was collected at baseline, 3 and 6 months for analysis of neurofilament heavy chain (NfH) and neurofilament light chain (NfL). Results: Sixty‐four patients had blood sampling. Of these, 58 and 56 were available at 3 months, and 55 and 54 were available at 6 months for NfH and NfL, respectively. There was no significant correlation between serum NfH and NfL at the time points tested. For NfH, the difference in mean placebo – phenytoin was −44 pg/ml at 3 months (P = 0.019) and −27 pg/ml at 6 months (P = 0.234). For NfL, the difference was 1.4 pg/ml at 3 months (P = 0.726) and −1.6 pg/ml at 6 months (P = 0.766). Conclusions: At 3 months, there was a reduction in NfH, but not NFL, in the phenytoin versus placebo group, while differences at 6 months were not statistically significant. This suggests a potential neuroprotective role for phenytoin in acute ON, with the lower NfH at 3 months, when levels secondary to degeneration of the anterior visual pathway are still elevated, but not at 6 months, when levels have normalized. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Label: Title
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  Data: Neurofilament results for the phase II neuroprotection study of phenytoin in optic neuritis.
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  Data: <searchLink fieldCode="AR" term="%22Raftopoulos%2C+R%2E%22">Raftopoulos, R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kuhle%2C+J%2E%22">Kuhle, J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Grant%2C+D%2E%22">Grant, D.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hickman%2C+S%2E+J%2E%22">Hickman, S. J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Altmann%2C+D%2E+R%2E%22">Altmann, D. R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Leppert%2C+D%2E%22">Leppert, D.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Blennow%2C+K%2E%22">Blennow, K.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Zetterberg%2C+H%2E%22">Zetterberg, H.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kapoor%2C+R%2E%22">Kapoor, R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Giovannoni%2C+G%2E%22">Giovannoni, G.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gnanapavan%2C+S%2E%22">Gnanapavan, S.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Feb2021, Vol. 28 Issue 2, p587-594. 8p.
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  Data: <searchLink fieldCode="DE" term="%22Optic+neuritis%22">Optic neuritis</searchLink><br /><searchLink fieldCode="DE" term="%22Cytoplasmic+filaments%22">Cytoplasmic filaments</searchLink><br /><searchLink fieldCode="DE" term="%22Phenytoin%22">Phenytoin</searchLink><br /><searchLink fieldCode="DE" term="%22Visual+pathways%22">Visual pathways</searchLink><br /><searchLink fieldCode="DE" term="%22Nerve+fibers%22">Nerve fibers</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: A randomized trial of phenytoin in acute optic neuritis (ON) demonstrated a 30% reduction in retinal nerve fiber layer (RNFL) loss with phenytoin versus placebo. Here we present the corresponding serum neurofilament analyses. Methods: Eighty‐six acute ON cases were randomized to receive phenytoin (4–6 mg/kg/day) or placebo for 3 months, and followed up for 6 months. Serum was collected at baseline, 3 and 6 months for analysis of neurofilament heavy chain (NfH) and neurofilament light chain (NfL). Results: Sixty‐four patients had blood sampling. Of these, 58 and 56 were available at 3 months, and 55 and 54 were available at 6 months for NfH and NfL, respectively. There was no significant correlation between serum NfH and NfL at the time points tested. For NfH, the difference in mean placebo – phenytoin was −44 pg/ml at 3 months (P = 0.019) and −27 pg/ml at 6 months (P = 0.234). For NfL, the difference was 1.4 pg/ml at 3 months (P = 0.726) and −1.6 pg/ml at 6 months (P = 0.766). Conclusions: At 3 months, there was a reduction in NfH, but not NFL, in the phenytoin versus placebo group, while differences at 6 months were not statistically significant. This suggests a potential neuroprotective role for phenytoin in acute ON, with the lower NfH at 3 months, when levels secondary to degeneration of the anterior visual pathway are still elevated, but not at 6 months, when levels have normalized. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Text: English
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      – SubjectFull: Optic neuritis
        Type: general
      – SubjectFull: Cytoplasmic filaments
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      – SubjectFull: Phenytoin
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      – SubjectFull: Visual pathways
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              Text: Feb2021
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