Multiple sclerosis diagnostics

Because disease onset typically occurs in young adulthood and can lead to permanent, progressive disability,  the impact extends far beyond individual physical symptoms, affecting emotional well-being, family dynamics, and global economic health.^2,5,6 Key dimensions of MS disease burden include: 

• Impact in peak life years: The global average age of diagnosis is 32 years.⁷ Onset typically strikes during early adulthood—a pivotal time when individuals are establishing careers, pursuing education, or starting families.
• Physical and progressive disability: Silent, ongoing neurological damage occurs continuously from disease onset—even when a patient appears clinically stable and has no active relapses.⁵ Without management, this accumulated damage leads to permanent loss of mobility and independence.
• Caregiver and family strain: As daily tasks become increasingly challenging, reliance on caregiving grows. This shift often places severe physical, emotional, and psychological stress on family members and caregivers.
• Economic and health system strain: MS demands lifelong medical resources. The financial strain encompasses high direct medical expenses (treatments, therapies, and specialized care) alongside indirect costs, such as loss of employment productivity for both patients and their primary caregivers.

Why timely action matters

Because underlying progression occurs from the very beginning of the disease, diagnostic delays directly compound physical disability and socioeconomic hardship. Closer monitoring for early detection and intervention remain critical to preserving long-term quality of life.

Neurological damage in MS patients begins early, often before visible symptoms emerge. This lack of visibility emphasizes the need for early detection and intervention, yet there are currently limited real-time tracking tools for MS disease activity.

Relapsing-remitting multiple sclerosis (RRMS) progression is often “under the radar”, with neuroaxonal damage occurring below the threshold of clinical symptoms or standard MRI detection. While MRI provides a retrospective view of cumulative damage, clinicians require a dynamic, quantitative measure of ongoing neuroaxonal injury.^8-10

The current standard of care for MS diagnosis includes assessment tools that have high clinical utility but are costly and time-consuming, leading to accessibility issues. Alternative tools lack the standardization to detect subtle disease changes, limiting the accurate identification of disease activity and progression over time.^3,11

There is a pressing need for a personalized approach, with accessible and scalable solutions to catch early signs of RRMS disease activity and monitor treatment response.^12,13 By offering highly sensitive biomarker blood testing, laboratories can provide clinicians with an accessible tool to help frequently monitor subclinical disease activity, complementing traditional imaging.^9,14

While traditional MRI reflects cumulative structural damage at fixed time points, it can lag behind active neuroaxonal injury. Integrating minimally invasive NfL testing bridges this gap by enabling frequent, accessible monitoring of subclinical disease activity between routine scans—supporting timely reassurance or personalized intervention.^9,14

Although a single serum NfL measurement provides a checkpoint, its greatest clinical power lies in longitudinal tracking. Serial measurements allows clinicians to predict future disease activity, assess relapse risk, and track brain atrophy over time, creating a dynamic, personalized approach to MS management.^8,10,17,18

Fully automated processing across cobas® e platforms delivers high-precision results while reducing variability from manual handling. Roche cobas® diagnostic analyzers are designed to rapidly integrate into laboratory workflows. 

The Roche Elecsys® NfL assay can be used on the automated cobas® e 801 and cobas® e 402 platforms, allowing labs to choose an instrument that meets their size and throughput requirements.¹⁴