Treatment strategies and responses for attacks of neuromyelitis optica spectrum disorder: A real-world retrospective cohort study

J Neurol Sci. 2024 Jul 15:462:123099. doi: 10.1016/j.jns.2024.123099. Epub 2024 Jun 14.

Abstract

We aimed to assess the treatment strategies utilized in patients with neuromyelitis optica spectrum disorder (NMOSD) experiencing relapses, including their frequency, types, and response after 6 months based on the Expanded Disability Status Scale (EDSS) score.

Methods: We conducted a retrospective study involving NMOSD patients from the Argentinean MS and NMOSD registry (RelevarEM, NCT03375177). Treatment response at 6 months was categorized as "good" if the EDSS score decreased by ≥1 point after a nadir EDSS score ≤ 3, or by ≥2 points after a nadir EDSS score > 3, "poor" if the EDSS score decrease was slighter, and as "absent" if the EDSS score remained unchanged or worsened.

Results: We included 120 NMOSD patients (seropositive N = 75), who experienced 250 NMOSD-related relapses and received 248 treatments. At 6 months, complete recovery was achieved in 70/98 (71.4%) and 15/19 (79%) patients, respectively. Predictors of a "good" response in our regression model were a younger age at disease onset (OR:3.54, CI95% 2.45-5.01, p < 0.0001) and a short delay from onset of relapse to treatment initiation (OR:1.56, CI95% 1.22-2.13, p = 0.004).

Conclusions: Approximately two-thirds of patients experienced complete recovery, and younger age and a short delay to start treatment were independent predictors of a "good" response.

Keywords: NMOSD; Prognosis; Relapses; Response; Treatment.

MeSH terms

  • Adult
  • Cohort Studies
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuromyelitis Optica* / drug therapy
  • Neuromyelitis Optica* / therapy
  • Recurrence
  • Registries
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult