A retrospective single-center study evaluated the Octave® MSDA Test (18-protein blood-based assay) in 66 adults with relapsing-remitting MS — 33 with acute neurological symptoms and 33 undergoing routine surveillance — comparing the composite Disease Activity Score (DAS) and individual proteins to gadolinium-enhancing lesions on MRI (April 2025–February 2026).
A DAS ≥ 6.0–10.0 was highly sensitive and specific for gadolinium enhancement across both cohorts. The DAS outperformed NfL alone (AUC 98.06% vs. 82.75%; difference 15.3%, p = 0.0061). Elevated MOG (p = 0.013) and NfL (p < 0.0001), and reduced BAFF/TNFSF13B (p < 0.0001), were independently associated with enhancement. In 79% of symptomatic cases, MSDA testing was completed before MRI.
- Single academic center with a mostly white, female cohort (n=66), limiting generalizability. - No adjustment for multiple testing; retrospective design. - BMI and renal function — both known NfL confounders — were not captured.
In patients presenting with possible MS relapse, a blood-based 18-protein panel (DAS ≥ 6.0) may help identify true inflammatory activity before MRI is available, potentially reducing empiric steroid use in pseudoexacerbations. A low DAS (1.0–5.5) may support a pseudoexacerbation diagnosis and warrant watchful waiting over immediate glucocorticoid treatment.
Explore related topics
