Factors associated with disease relapse rate in the Neuromyelitis optica spectrum disorder

Int J Neurosci. 2024 Oct;134(10):1114-1119. doi: 10.1080/00207454.2023.2238245. Epub 2023 Jul 26.

Abstract

Background and objectives: Neuromyelitis optica spectrum disorder (NMOSD) is a group of demyelinating diseases of the nervous system with high relapse rate and high disability rate without treatment, and we aimed to explore the influencing factors related to the recurrence of NMOSD and provide basis for clinical treatment in this study.

Methods: Referring to the diagnostic criteria for NMOSD issued in 2015, 259 patients were enrolled. Clinical information, cerebrospinal fluid (CSF) and serum analysis results, brain and spinal cord magnetic resonance imaging (MRI) findings, treatment details, and prognosis were all recorded.

Results: 176 (68.00%) participants were found to be AQP4 Ab-positive in serum or CSF, and the relapse rate was 36.67% (95/259). These 259 individuals were separated into two groups: non-release (n = 164) and relapse (n = 95). In terms of EDSS scores at onset, EDSS score after treatment, lesion location, serum creatinine (Cr) and treatment strategy, there were statistical differences between the two groups. Multivariable logistic regression analyses revealed five predictors for recurrence of NMOSD patients within two years: EDSS scores at onset, transverse myelitis, brain/brainstem, Cr, and Rituximab/immunosuppressants.

Conclusion: It is essential to explore the risk factors related to recurrence and prevent them to reduce the risk of disability and improve the prognosis, and the recurrence rate of NMOSD may be affected by several factors.

Keywords: AQP4; Neuromyelitis optica spectrum disorder; expanded disability status scale; immunosuppressants; relapse.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aquaporin 4* / immunology
  • Autoantibodies / blood
  • Autoantibodies / cerebrospinal fluid
  • Brain / diagnostic imaging
  • Brain / pathology
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuromyelitis Optica* / blood
  • Neuromyelitis Optica* / diagnosis
  • Neuromyelitis Optica* / diagnostic imaging
  • Recurrence*
  • Risk Factors
  • Young Adult

Substances

  • Aquaporin 4
  • AQP4 protein, human
  • Autoantibodies