Predictors of relapse risk and treatment response in AQP4-IgG positive and seronegative NMOSD: A multicentre study
Jazyk angličtina Země Velká Británie, Anglie Médium electronic
Typ dokumentu časopisecké články, multicentrická studie
PubMed
39231582
DOI
10.1136/jnnp-2024-334090
PII: jnnp-2024-334090
Knihovny.cz E-zdroje
- Klíčová slova
- HEALTH ECONOMICS, IMMUNOLOGY, MEDICINE, MULTIPLE SCLEROSIS, NEUROIMMUNOLOGY,
- MeSH
- akvaporin 4 * imunologie MeSH
- autoprotilátky * krev MeSH
- dospělí MeSH
- imunoglobulin G * krev imunologie MeSH
- imunosupresiva terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- neuromyelitis optica * imunologie farmakoterapie terapie MeSH
- proporcionální rizikové modely MeSH
- recidiva MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Názvy látek
- akvaporin 4 * MeSH
- AQP4 protein, human MeSH Prohlížeč
- autoprotilátky * MeSH
- imunoglobulin G * MeSH
- imunosupresiva MeSH
BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) can be categorised into aquaporin-4 antibody (AQP4-IgG) NMOSD or seronegative NMOSD. While our knowledge of AQP4-IgG NMOSD has evolved significantly in the past decade, seronegative NMOSD remains less understood. This study aimed to evaluate the predictors of relapses and treatment responses in AQP4-IgG NMOSD and seronegative NMOSD. METHODS: This was a multicentre, international, retrospective cohort study using the MSBase registry. Recurrent relapse risk was assessed using an Andersen-Gill model and risk of first relapse was evaluated using a Cox proportional hazards model. Covariates that putatively influence relapse risk included demographic factors, clinical characteristics and immunosuppressive therapies; the latter was assessed as a time-varying covariate. RESULTS: A total of 398 patients (246 AQP4-IgG NMOSD and 152 seronegative NMOSD) were included. The AQP4-IgG NMOSD and seronegative NMOSD patients did not significantly differ by age at disease onset, ethnicity or annualised relapse rate. Both low-efficacy and high-efficacy immunosuppressive therapies were associated with significant reductions in recurrent relapse risk, with notably greater protection conferred by high-efficacy therapies in both AQP4-IgG NMOSD (HR 0.27, 95% CI 0.15 to 0.49, p<0.001) and seronegative NMOSD (HR 0.21, 95% CI 0.08 to 0.51, p<0.001). Longer disease duration (HR 0.97, 95% CI 0.95 to 0.99, p<0.001) and male sex (HR 0.52, 95% CI 0.34 to 0.84, p=0.007) were additional protective variables in reducing the recurrent relapse risk for the AQP4-IgG NMOSD group. CONCLUSION: Although further studies are needed to improve our understanding of seronegative NMOSD, our findings underscore the importance of aggressive treatment with high-efficacy immunotherapies in both NMOSD subtypes, regardless of serostatus.
Alfred Health Department of Neurology Melbourne Victoria Australia
American University of Beirut Beirut Lebanon
Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases Istanbul Turkey
Biocruces Bizkaia Health Research Institute Barakaldo Spain
Department of Biotechnological and Applied Clinical Sciences University of L'Aquila L'Aquila Italy
Department of Medicine CORe University of Melbourne Melbourne Victoria Australia
Department of Neurology Haydarpasa Numune Training and Research Hospital Istanbul Turkey
Department of Neurology Royal Brisbane Hospital Brisbane Queensland Australia
Department of Neurology Royal Melbourne Hospital Melbourne Victoria Australia
Department of Neurology Semmelweis University Budapest Hungary
Department of Neurology Universitair Ziekenhuis Gent Gent Belgium
Department of Neurology University of Debrecen Debrecen Hungary
Department of Neuroscience MS Center Neurology Unit S Maria delle Croci Hospital Ravenna Italy
Department of Neuroscience S Maria delle Croci Hospital Ravenna Italy
Division of Neurology Department of Medicine Amiri Hospital Kuwait City Kuwait
Faculty of Medicine Isfahan University of Medical sciences Isfahan Iran
Hunter Medical Research Institute The University of Newcastle Newcastle New South Wales Australia
Hunter New England Health John Hunter Hospital New Lambton Heights New South Wales Australia
Izmir University of Economics Medical Point Hospital İzmir Turkey
Multiple Sclerosis Research Association Izmir Turkey
Multiple Sclerosis Unit AOU Policlinico G Rodolico San Marco University of Catania Catania Italy
Neurology Department Harley Street Medical Centre Abu Dhabi UAE
Neurology Dr Etemadifar MS Institute Isfahan Iran
Neurology Galdakao Usanosolo University Hospital Osakidetza Basque Health Service Galdakao Spain
Neurology Royal Hobart Hospital Hobart Tasmania Australia
Neurology Universitair Ziekenhuis Antwerpen Edegem Belgium
Neurology Walton Centre for Neurology and Neurosurgery Liverpool UK
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