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Document type
články
články
Document record
Source: BMČ - články
Title
Clinical and therapeutic predictors of disease outcomes in AQP4-IgG+ neuromyelitis optica spectrum disorder / A. Kunchok, C. Malpas, P. Nytrova, EK. Havrdova, R. Alroughani, M. Terzi, B. Yamout, JY. Hor, R. Karabudak, C. Boz, S. Ozakbas, J. Olascoaga, M. Simo, F. Granella, F. Patti, P. McCombe, T. Csepany, B. Singhal, R. Bergamaschi, Y. Fragoso, T. Al-Harbi, R. Turkoglu, J. Lechner-Scott, G. Laureys, C. Oreja-Guevara, E. Pucci, P. Sola, D. Ferraro, A. Altintas, A. Soysal, S. Vucic, F. Grand'Maison, G. Izq
Author
Kunchok, Amy
CORe, Department of Medicine, University of Melbourne, Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia. Electronic address: kunchok.amy@mayo.edu

Malpas, Charles
CORe, Department of Medicine, University of Melbourne, Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia

Nytrova, Petra
Department of Neurology and Center of clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic

Havrdova, Eva Kubala
Department of Neurology and Center of clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic

Alroughani, Raed
Division of Neurology, Department of Medicine, Amiri Hospital, P.O.Box 1661. Qurtoba, Sharq, 73767, Kuwait

Terzi, Murat
Medical Faculty, 19 Mayis University, Kurupelit, Samsun, 55160, Turkey

Yamout, Bassem
Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon

Hor, Jyh Yung
Department of Neurology, Penang General Hospital, Penang, Malaysia

Karabudak, Rana
Hacettepe University, Sihhiye, Ankara, 6100, Turkey

Boz, Cavit
KTU Medical Faculty Farabi Hospital, Karadeniz Technical University, Trabzon, 61080, Turkey

Ozakbas, Serkan
Dokuz Eylul University, Cumhuriyet Blv 144, Konak/Izmir, 35220, Turkey

Olascoaga, Javier
Instituto Vasco de Investigación Sanitaria, Hospital UniversitarioDonostia, Paseo de Begiristain, San Sebastián, 20014, Spain

Simo, Magdolna
Semmelweis University Budapest, Balassa, Budapest, 1083, Hungary

Granella, Franco
Department of Medicine and Surgery, University of Parma, via Gramsci 14, Parma, 43126, Italy

Patti, Francesco
GF Ingrassia Department, University of Catania, Policlinico G Rodolico Via Santa Sofia 78, 95123 Catania, Italy

McCombe, Pamela
Department of Neurology, Royal Brisbane and Women's Hospital, Herston, Brisbane, 4029, Australia

Csepany, Tunde
Department of Neurology, Faculty of Medicine, University of Debrecen, Moricz Zs. krt 22, Debrecen, 4032, Hungary

Singhal, Bhim
Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra 400020, India

Bergamaschi, Roberto
IRCCS Mondino Foundation, via Mondino 2, Pavia, 27100, Italy

Fragoso, Yara
Universidade Metropolitana de Santos, Santos, Brazil

Al-Harbi, Talal
Neurology Department, King Fahad Specialist Hospital-Dammam, Al Muraikebat Area, Ammar Bin Thabet Street. P.O. Box 15215, Dammam 31444, Saudi Arabia

Turkoglu, Recai
Haydarpasa Numune Training and Research Hospital, Selimiye Mahallesi, Istanbul, 34668, Turkey

Lechner-Scott, Jeannette
School of Medicine and Public Health, Department of Neurology, University Newcastle, Lookout Road, John Hunter Hospital, Hunter New England Health, Newcastle, 2305, Australia

Laureys, Guy
Universitary Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium

Oreja-Guevara, Celia
Hospital Universitario La Paz, Madrid, Spain

Pucci, Eugenio
UOC Neurologia, Azienda Sanitaria Unica Regionale Marche - AV3, Via Santa Lucia 2, Macerata, 62100, Italy

Sola, Patrizia
Department of Neuroscience, Azienda Ospedaliera Universitaria, via giardini 1355, Modena, 41100, Italy

Ferraro, Diana
Department of Neuroscience, Azienda Ospedaliera Universitaria, via giardini 1355, Modena, 41100, Italy

Altintas, Ayse
Koc University, School of Medicine, Department of Neurology, Davutpasa, Istanbul, Turkey

Soysal, Aysun
Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey

Vucic, Steve
Department of Neurology, Westmead Hospital, NSW 2145, Sydney, Australia

Grand'Maison, Francois
Neuro Rive-Sud, 4896 boul. Taschereau, suite 250, Quebec, J4V 2J2, Canada

Izquierdo, Guillermo
Neuro Rive-Sud, 4896 boul. Taschereau, suite 250, Quebec, J4V 2J2, Canada

Eichau, Sara
Hospital Universitario Virgen Macarena, Dr Fedriani 3, Sevilla, 41009, Spain

Lugaresi, Alessandra
IRCCS Istituto delle Scienze Neurologiche di Bologna, University of Bologna, Via Altura 3A, 40139, Bologna, Italy; Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Italy

Onofrj, Marco
Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Italy

Trojano, Maria
Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy

Marriott, Mark
Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia

Butzkueven, Helmut
Monash University, Department of Neurology, Alfred Hospital, Melbourne, Australia

Kister, Ilya
New York University Langone Medical Center, 240 East 38th St, New York, 10016, United States

Kalincik, Tomas
CORe, Department of Medicine, University of Melbourne, Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia. Electronic address: tomas.kalincik@unimelb.edu.au

Cited source
Multiple sclerosis and related disorders. 2020, roč. 38, č. -, s. 101868. ISSN: 2211-0348; 2211-0356 (online).
Date of issue
2020
Language
angličtina
Country
Nizozemsko
Document type
články
DOI
Pubmed ID
Link
Record number
bmc21012894
Persistent link
English Abstract
BACKGROUND: Aquaporin-4-IgG positive (AQP4-IgG+) Neuromyelitis Optica Spectrum Disorder (NMOSD) is an uncommon central nervous system autoimmune disorder. Disease outcomes in AQP4-IgG+NMOSD are typically measured by relapse rate and disability. Using the MSBase, a multi-centre international registry, we aimed to examine the impact immunosuppressive therapies and patient characteristics as predictors of disease outcome measures in AQP4-IgG+NMOSD. METHOD: This MSBase cohort study of AQP4-IgG+NMOSD patients examined modifiers of relapse in a multivariable proportional hazards model and expanded disability status score (EDSS) using a mixed effects model. RESULTS: 206 AQP4-IgG+ patients were included (median follow-up 3.7 years). Age (hazard ratio [HR] = 0.82 per decade, p = 0.001), brainstem onset (HR = 0.45, p = 0.009), azathioprine (HR = 0.46, p<0.001) and mycophenolate mofetil (HR = 0.09, p = 0.012) were associated with a reduced risk of relapse. A greater EDSS was associated with age (β = 0.45 (per decade), p<0.001) and disease duration (β = 0.07 per year, p<0.001). A slower increase in EDSS was associated with azathioprine (β = -0.48, p<0.001), mycophenolate mofetil (β = -0.69, p = 0.04) and rituximab (β = -0.35, p = 0.024). INTERPRETATION: This study has demonstrated that azathioprine and mycophenolate mofetil reduce the risk of relapses and disability progression is modified by azathioprine, mycophenolate mofetil and rituximab. Age and disease duration were the only patient characteristics that modified the risk of relapse and disability in our cohort.
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