BACKGROUND: Debate exists about whether neuromyelitis optica spectrum disorder seronegative disease represents the same immune-mediated attack on astrocytic aquaporin-4 as in seropositive disease. OBJECTIVE: We investigated whether response to common treatments for neuromyelitis optica spectrum disorder differed by serostatus, as assessed by change in annualized relapse rate. METHODS: We performed a multicenter retrospective analysis of 245 patients with neuromyelitis optica spectrum disorder who were treated with either rituximab or mycophenolate mofetil as their first-line immunosuppressive treatment for disease prevention. Patients were followed for a minimum of 6 months following treatment initiation. RESULTS: In those started on rituximab, the pre-treatment annualized relapse rates for seropositive and seronegative patients were 1.81 and 1.93, respectively. On-treatment annualized relapse rates significantly declined to 0.32 (seropositive; p < 0.0001) and 0.12 (seronegative; p = 0.0001). In those started on mycophenolate mofetil, the pre-treatment annualized relapse rates for seropositive and seronegative patients were 1.79 and 1.45, respectively. On-treatment annualized relapse rates declined to 0.29 (seropositive; p < 0.0001) and 0.30 (seronegative; p < 0.005). CONCLUSION: In this international collaboration involving a large number of neuromyelitis optica spectrum disorder patients, treatment was effective regardless of serostatus. This suggests that treatment should not differ when considering these treatments.
BACKGROUND: Debate exists about whether neuromyelitis optica spectrum disorder seronegative disease represents the same immune-mediated attack on astrocytic aquaporin-4 as in seropositive disease. OBJECTIVE: We investigated whether response to common treatments for neuromyelitis optica spectrum disorder differed by serostatus, as assessed by change in annualized relapse rate. METHODS: We performed a multicenter retrospective analysis of 245 patients with neuromyelitis optica spectrum disorder who were treated with either rituximab or mycophenolate mofetil as their first-line immunosuppressive treatment for disease prevention. Patients were followed for a minimum of 6 months following treatment initiation. RESULTS: In those started onrituximab, the pre-treatment annualized relapse rates for seropositive and seronegative patients were 1.81 and 1.93, respectively. On-treatment annualized relapse rates significantly declined to 0.32 (seropositive; p < 0.0001) and 0.12 (seronegative; p = 0.0001). In those started onmycophenolate mofetil, the pre-treatment annualized relapse rates for seropositive and seronegative patients were 1.79 and 1.45, respectively. On-treatment annualized relapse rates declined to 0.29 (seropositive; p < 0.0001) and 0.30 (seronegative; p < 0.005). CONCLUSION: In this international collaboration involving a large number of neuromyelitis optica spectrum disorderpatients, treatment was effective regardless of serostatus. This suggests that treatment should not differ when considering these treatments.
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Authors: Dean M Wingerchuk; Brenda Banwell; Jeffrey L Bennett; Philippe Cabre; William Carroll; Tanuja Chitnis; Jérôme de Seze; Kazuo Fujihara; Benjamin Greenberg; Anu Jacob; Sven Jarius; Marco Lana-Peixoto; Michael Levy; Jack H Simon; Silvia Tenembaum; Anthony L Traboulsee; Patrick Waters; Kay E Wellik; Brian G Weinshenker Journal: Neurology Date: 2015-06-19 Impact factor: 9.910
Authors: Esther Melamed; Michael Levy; Patrick J Waters; Douglas Kazutoshi Sato; Jeffrey L Bennett; Gareth R John; Douglas C Hooper; Albert Saiz; Amit Bar-Or; Ho Jin Kim; Lakha Pandit; Maria Isabel Leite; Nasrin Asgari; Najib Kissani; Rogier Hintzen; Romain Marignier; Sven Jarius; John Marcelletti; Terry J Smith; Michael R Yeaman; May H Han; Orhan Aktas; Metha Apiwattanakul; Brenda Banwell; Denis Bichuetti; Simon Broadley; Philippe Cabre; Tanuja Chitnis; Jerome De Seze; Kazuo Fujihara; Benjamin Greenberg; Kerstin Hellwig; Raffaele Iorio; Sven Jarius; Eric Klawiter; Ingo Kleiter; Marco Lana-Peixoto; Kevin O'Connor; Jacqueline Palace; Friedman Paul; Naraporn Prayoonwiwat; Klemens Ruprecht; Olaf Stuve; Thomas Tedder; Silvia Tenembaum; Juan P Garrahan; Buenos Aires; Katja van Herle; Danielle van Pelt; Pablo Villoslada; Emmanuelle Waubant; Brian Weinshenker; Dean Wingerchuk; Jens Würfel; Scott Zamvil Journal: Neurol Neuroimmunol Neuroinflamm Date: 2015-07-23
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