Journal article
Response to treatment in NMOSD: the Australasian experience
Multiple Sclerosis and Related Disorders, Vol.58, Art. 103408
2021
Abstract
Background: Neuromyelitis optica spectrum disorder (NMOSD) is associated with significant morbidity and mortality. Several therapies have been recommended for NMOSD and more recently clinical trials have demonstrated efficacy for three monoclonal antibody therapies. We present a retrospective observational study of treatment response in NMOSD.
Methods: This was a retrospective, unblinded, observational study of treatment efficacy for rituximab and traditional immunosuppressive therapy in patients with AQP4 antibody positive NMOSD. Treatment efficacy was assessed using annualised relapse rates (ARR), time to first relapse and expanded disability status scale (EDSS) scores.
Results: Complete relapse and treatment data were available for 43/68 (63%) of AQP4 antibody positive NMOSD cases covering 74 episodes of treatment. In a time to first relapse analysis rituximab showed a risk ratio of 0.23 (95% CI 0.08 – 0.65) when compared with no treatment and there was a non-significant reduction in ARR of 35% compared to pre-treatment. β-interferon (p = 0.0002) and cyclophosphamide (p = 0.0034) were associated with an increased ARR compared to pre-treatment. Rituximab (median 4.0 [range 0.0 – 7.0]; p = 0.042) and traditional immunosuppressive therapy (median 4.0 [range 0.0 – 8.0]; p = 0.016) were associated with a lower final EDSS compared to β-interferon (median 6.0 [range 4.0 – 7.5]).
Conclusions: These data provide additional support for the use of rituximab in preference to traditional immunosuppressive agents and MS disease modifying therapies as first line treatment of NMOSD.
NMOSD, neuromyelitis optica; AQP4, aquaporin-4 ARR, annualised relapse rate; EDSS, expanded disability status scale; CNS, central nervous system; MS, multiple sclerosis; SD, standard deviation; RR, relative risk; CI, confidence interval; LESCL, longitudinally extensive spinal cord lesion; IVMP, intravenous methylprednisolone; Rx, treatment; IRR, incidence rate ratio
Details
- Title
- Response to treatment in NMOSD: the Australasian experience
- Authors/Creators
- L. Clarke (Author/Creator) - Griffith UniversityW. Bukhari (Author/Creator) - Griffith UniversityC.M. O'Gorman (Author/Creator) - Griffith UniversityE. Khalilidehkordi (Author/Creator) - Griffith UniversityS. Arnett (Author/Creator) - Griffith UniversityM. Woodhall (Author/Creator) - John Radcliffe HospitalK.M. Prain (Author/Creator) - Royal Brisbane and Women's HospitalJ.D.E. Parratt (Author/Creator)M.H. Barnett (Author/Creator) - The University of SydneyM.P. Marriott (Author/Creator) - The Royal Melbourne HospitalP.A. McCombe (Author/Creator) - Royal Brisbane and Women's HospitalI. Sutton (Author/Creator) - St Vincent's Hospital SydneyM. Boggild (Author/Creator) - Townsville HospitalW. Brownlee (Author/Creator) - Auckland City HospitalW.M. Carroll (Author/Creator) - Perron Institute for Neurological and Translational ScienceS. Hodgkinson (Author/Creator) - Liverpool HospitalR.A.L. Macdonell (Author/Creator) - Austin HealthD.F. Mason (Author/Creator) - Christchurch HospitalJ. Pereira (Author/Creator) - Auckland City HospitalM. Slee (Author/Creator) - Flinders Medical CentreC. Das (Author/Creator)A.P.D. Henderson (Author/Creator)A.G. Kermode (Author/Creator)J. Lechner-Scott (Author/Creator)P. Waters (Author/Creator)J. Sun (Author/Creator)S.A. Broadley (Author/Creator)
- Publication Details
- Multiple Sclerosis and Related Disorders, Vol.58, Art. 103408
- Publisher
- Elsevier B.V.
- Identifiers
- 991005540108007891
- Copyright
- © 2021 Published by Elsevier B.V.
- Murdoch Affiliation
- Institute for Immunology and Infectious Diseases
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
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- Citation topics
- 1 Clinical & Life Sciences
- 1.203 Neuromuscular Disorders
- 1.203.147 Multiple Sclerosis
- Web Of Science research areas
- Clinical Neurology
- ESI research areas
- Neuroscience & Behavior