Octave MSDA Test Proven Effective in Identifying True MS Relapse
Octave Bioscience, a commercial-stage precision neurology company focused on advancing personalized care for multiple sclerosis (MS) and other neurodegenerative disorders, has announced the publication of new independent research demonstrating the clinical utility of its Octave® Multiple Sclerosis Disease Activity (MSDA) Test. The investigator-initiated study, published in the peer-reviewed journal Neurology and Therapy, evaluated the blood-based biomarker test’s ability to distinguish between a true inflammatory relapse and a pseudoexacerbation—one of the most challenging clinical decisions in the management of multiple sclerosis.
The findings suggest that the MSDA Test may provide physicians with valuable objective biological information that complements clinical examination and MRI imaging, helping improve treatment decisions for patients who present with new or worsening neurological symptoms. The research also demonstrated that the multi-protein MSDA Test outperformed neurofilament light chain (NfL), one of the most widely studied blood biomarkers for neurological injury, in identifying active inflammatory disease.
Addressing a Critical Challenge in Multiple Sclerosis Care
Multiple sclerosis is a chronic autoimmune disease in which the immune system attacks the protective covering of nerve fibers within the central nervous system. Disease activity can fluctuate over time, with patients experiencing periods of neurological worsening known as relapses, followed by varying degrees of recovery.
However, not every worsening of symptoms represents a true inflammatory relapse.
Many patients experience what clinicians refer to as pseudoexacerbations—temporary symptom worsening triggered by factors such as infection, fever, stress, fatigue, or elevated body temperature. Although these episodes may closely resemble an MS relapse, they do not reflect new inflammatory damage within the brain or spinal cord.
Distinguishing between these two conditions is often difficult because the symptoms can appear nearly identical during clinical evaluation.
Making the correct diagnosis is critically important because treatment strategies differ substantially. Patients experiencing a true inflammatory relapse may require corticosteroid therapy or additional diagnostic imaging, whereas pseudoexacerbations are generally managed by addressing the underlying trigger rather than escalating immunologic treatment.
Accurate and timely identification of disease activity therefore plays a central role in optimizing patient outcomes while avoiding unnecessary treatments and healthcare costs.
Evaluating the MSDA Test
The newly published retrospective observational study examined whether Octave’s blood-based Multiple Sclerosis Disease Activity Test could help clinicians differentiate true inflammatory relapses from pseudoexacerbations.
Researchers enrolled 66 individuals with relapsing multiple sclerosis who were treated at a single academic medical center.
Investigators compared each participant’s MSDA Disease Activity Score with MRI findings to determine how accurately the blood test reflected active inflammatory disease.
As the reference standard, researchers used the presence of gadolinium-enhancing lesions on MRI scans, which are widely recognized as evidence of active inflammation in multiple sclerosis.
The study also compared the performance of the MSDA Test with neurofilament light chain (NfL), an established biomarker that has attracted considerable attention as a potential indicator of neuronal injury in MS and other neurological disorders.
Strong Diagnostic Performance
According to the study, the MSDA Test demonstrated excellent diagnostic accuracy in identifying patients with active inflammatory disease confirmed by MRI.
Among the key findings:
- The MSDA Disease Activity Score achieved 100% sensitivity, correctly identifying every patient with MRI-confirmed active inflammatory disease.
- The test demonstrated 94% specificity, accurately distinguishing patients who did not have active inflammation.
- The study reported a 100% negative predictive value, indicating that patients with a negative test result were highly unlikely to have MRI-confirmed inflammatory disease.
- Overall diagnostic performance significantly exceeded that of neurofilament light chain, with an area under the curve (AUC) of 98.1% compared with 82.8% for NfL.
These results suggest that the multi-analyte protein assay may provide more comprehensive biological information than relying on a single biomarker alone.
Earlier Biological Insight
Another important finding from the research involved the timing of testing.
In acute clinical situations, physicians often must decide whether patients require urgent MRI imaging or corticosteroid treatment before imaging results become available.
The investigators found that in 79% of acute cases, blood samples for the MSDA Test were obtained before MRI scans were performed.
This indicates that clinicians could potentially receive earlier biological information regarding disease activity while awaiting imaging studies, supporting more timely clinical decision-making.
Earlier access to objective biomarker data may be particularly valuable when MRI availability is limited or when rapid treatment decisions are necessary.
Supporting More Confident Clinical Decisions
Rather than replacing MRI or neurological examination, researchers emphasized that the MSDA Test is intended to complement existing diagnostic tools.
By providing an objective, quantitative measurement of disease activity, the blood test may help physicians determine:
- Whether symptoms likely represent an inflammatory relapse
- Whether MRI imaging is warranted
- Whether corticosteroid therapy should be initiated
- Whether symptoms are more consistent with a pseudoexacerbation
Providing additional biological evidence may help reduce uncertainty during some of the most challenging clinical scenarios encountered in MS management.
Investigator Perspective
Lead study author Dr. Darin T. Okuda, Professor of Neurology and Director of the Neuroinnovation Program and the Multiple Sclerosis and Neuroimmunology Imaging Program at the University of Texas Southwestern Medical Center, noted that distinguishing between inflammatory relapses and pseudoexacerbations remains one of the most difficult aspects of caring for patients with multiple sclerosis.
He explained that the study findings suggest the MSDA Test may provide clinicians with meaningful objective information that complements traditional clinical evaluation and MRI when assessing patients with new neurological symptoms.
Dr. Okuda also emphasized that while additional prospective research is still needed to further validate these observations, the study represents an important step toward improving evidence-based clinical decision-making through blood-based biomarkers.
Expanding Evidence for Blood-Based Biomarkers
Octave Bioscience believes the publication adds to a growing body of evidence supporting the clinical use of blood biomarkers in routine multiple sclerosis care.
According to Terrie Livingston, Vice President of Medical Affairs at Octave Bioscience, advances in biomarker science are allowing physicians to better understand the underlying biological activity occurring within each patient’s disease.
Earlier in 2026, additional data presented during the Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting demonstrated increasing adoption of the MSDA Test by healthcare providers across hundreds of medical institutions.
Livingston said the continued accumulation of clinical evidence reinforces the role of blood-based biomarkers as practical tools for monitoring disease activity and supporting treatment decisions.
She noted that understanding the biology driving disease progression allows clinicians to move beyond relying solely on symptoms and imaging, helping deliver more personalized care.
The Role of Precision Neurology
The publication also reflects the broader movement toward precision medicine in neurology.
Historically, neurologists have relied heavily on patient symptoms, neurological examination, and MRI findings to monitor multiple sclerosis.
While these tools remain essential, blood-based biomarkers offer an additional dimension by providing insight into ongoing biological processes that may not always be immediately apparent clinically.
Combining imaging, laboratory biomarkers, and clinical assessment may ultimately improve physicians’ ability to individualize treatment decisions and monitor therapeutic effectiveness.
For patients, this could translate into more precise disease management, earlier intervention during inflammatory activity, and fewer unnecessary treatments.
About the Octave MSDA Test
The Octave Multiple Sclerosis Disease Activity Test is currently the first and only commercially available blood test specifically designed to measure disease activity in multiple sclerosis using a multi-protein biomarker approach.
Unlike tests that rely on a single biomarker, the MSDA Test evaluates 18 validated protein biomarkers associated with multiple sclerosis biology.
These biomarkers collectively generate a Disease Activity Score intended to help physicians better understand inflammatory activity occurring within an individual patient.
The test is commercially available across the United States.
Healthcare providers can order the assay, while patients may undergo blood collection at any of approximately 7,000 Quest Diagnostics patient service centers nationwide.
Testing is performed at Octave Bioscience’s laboratory in Menlo Park, California, which is CLIA-certified, CAP-accredited, and approved under the New York State Clinical Laboratory Evaluation Program (CLEP).
The company also notes that the test is reimbursed by health insurance for eligible patients, with financial assistance programs available to help improve access.
With nearly one million Americans living with multiple sclerosis, the need for more objective tools to guide diagnosis and treatment remains significant. Differentiating true inflammatory relapses from pseudoexacerbations continues to be one of the most important and challenging decisions neurologists face in routine practice.
The newly published study adds independent evidence supporting the clinical utility of the Octave MSDA Test as an adjunct to neurological examination and MRI. By demonstrating high sensitivity, strong specificity, excellent negative predictive value, and superior performance compared with neurofilament light chain, the research highlights the potential role of multi-protein biomarker testing in modern MS management.
As additional prospective studies and real-world clinical experience continue to emerge, blood-based biomarkers may become an increasingly important component of precision neurology, helping physicians make more informed treatment decisions while providing patients with greater confidence and clarity during critical moments in their disease journey.
About Octave Bioscience, Inc.
Octave Bioscience, Inc. is a leading precision care company pioneering multi-analyte biomarker-driven solutions for neurodegenerative diseases, starting with multiple sclerosis. Octave’s comprehensive solution provides objective, actionable insights to improve disease monitoring, treatment decisions, and patient outcomes. The company’s flagship product, the Octave Multiple Sclerosis Disease Activity (MSDA) Test, is the first clinically and analytically validated blood-based biomarker test that enables physicians to quantitatively measure MS disease activity, allowing for more informed treatment decisions and personalized disease management over time.