Serum C-Reactive Protein as a Prognostic Biomarker in Amyotrophic Lateral Sclerosis

Area of Science:

• Neurology
• Biomarkers
• Inflammation

Background:

• Prognostic factors for amyotrophic lateral sclerosis (ALS) remain debated.
• C-reactive protein (CRP), a marker of inflammation, shows prognostic value in various diseases.

Purpose of the Study:

• To investigate the prognostic significance of C-reactive protein (CRP) in amyotrophic lateral sclerosis (ALS).

Main Methods:

• Serum CRP levels were analyzed in a large cohort of ALS patients (n=394) and validated in an independent cohort (n=116).
• Correlation with functional impairment (ALSFRS-R) and survival was assessed.
• A post hoc analysis of a phase 2 NP001 trial examined CRP's role in treatment response.

Main Results:

• Elevated serum CRP levels correlated with increased functional impairment and reduced survival in ALS patients.
• These findings were consistent across both primary and validation cohorts.
• In the NP001 trial, patients with high baseline CRP receiving higher NP001 doses showed less functional decline compared to those with normal CRP.

Conclusions:

• Elevated serum CRP levels are associated with more rapid disease progression and poorer survival in ALS.
• CRP may indicate a neuroinflammatory state in ALS.
• CRP levels could help identify ALS patients who may benefit from immunomodulatory treatments like NP001.