Risk factors associated with permanent disability in neuromyelitis optica spectrum disorders

Valdivia-Tangarife, Edgar R.; Gámez-Nava, Jorge I.; Cortés-Enríquez, Fernando; Mireles-Ramírez, Mario Alberto; Gonzalez-López, Laura; Saldaña-Cruz, Ana Miriam; Macías-Islas, Miguel Ángel

doi:10.1016/j.msard.2022.104114

Cited by 7 publications

(7 citation statements)

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“…aunque los datos específicos sobre este tema en América Latina no son precisos o no están bien establecidos. Mundialmente se han reportado 331 casos, incluyendo 10 en Latinoamérica (Valdivia-Tangarife et al, 2022). El trastorno afecta con más frecuencia a las mujeres, con una proporción de 5 mujeres por cada hombre, y suele manifestarse alrededor de los 39 años en promedio (Pedraza et al, 2019).…”

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Reporte de Caso: Neuromielitis Óptica

Méndez Guerrero,

Mejía Almeida

2023

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Antecedentes: La Neuromielitis Óptica, también llamada enfermedad de Devic, es una entidad autoinmune desmielinizante del Sistema Nervioso Central, poco común que compromete los nervios ópticos y la médula espinal, ocasionando pérdida de la agudeza visual y afección motora. Descripción del caso: se presenta el caso clínico de una mujer de 25 años, que presenta signos de mielopatía y amaurosis súbitas, cumpliendo criterios para neuromielitis óptica. Se inicia tratamiento interrumpiendo embarazo para luego seguir con bolos de metilprednizona lo que al no existir mejoría comenzamos con terapia biológica dando resultado positivo desde la primera dosis. El Rituximab pertenece al grupo de anticuerpos monoclonales anti – CD20, una opción importante ante la falta de respuesta a la primera línea de tratamiento. Objetivo: Determinar el perfil clínico y terapéutico de los pacientes con diagnóstico de neuromielitis óptica. Conclusión: La paciente sufre de Neuromielitis óptica, experimentando problemas de visión y movilidad, con una nota de 18 puntos en la EDSS, a pesar del tratamiento con metilprednisolona intravenosa que no ha mostrado mejoría. Sin embargo, al administrar el medicamento Rituximab, un anticuerpo monoclonal anti-CD20, de forma semanal durante cuatro dosis, se observa una mejoría notable en su condición clínica, reflejada en una calificación final en la escala EDSS de 8 puntos. Área de estudio general: medicina. Área de estudio específica: Neurología.

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“…3. pp. 6 -18. julioseptiembre 2023 www.alfapublicaciones.com palidez del disco óptico (edema, atrofia o papila pálida) (Valdivia-Tangarife et al, 2022;Abreo et al, 2022).…”

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Reporte de Caso: Neuromielitis Óptica

Méndez Guerrero,

Mejía Almeida

2023

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“…Patients with NMOSD often experience a higher number of deficits, such as physical disability, depression, anxiety, cognitive impairment (CI), pain, and fatigue that reduces the quality of life. 5 – 13 …”

Section: Introductionmentioning

confidence: 99%

Frequency of cognitive impairment in patients with neuromyelitis optica spectrum disorder in Mexico

Valdivia-Tangarife,

Cortés-Enríquez,

Morlett-Paredes

et al. 2024

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Background Between 29% and 67% of neuromyelitis optica spectrum disorder patients have cognitive alterations. Objective To assess the frequency of cognitive impairment in patients with neuromyelitis optica spectrum disorder in Mexico using the Brief International Cognitive Assessment for Multiple Sclerosis. Methods We evaluated 40 neuromyelitis optica spectrum disorder patients and 40 healthy controls from Mexico. Results 28 (70.0%) patients with neuromyelitis optica spectrum disorder had cognitive impairment in two or more cognitive domains. Student´s T test showed statistically poor performance by neuromyelitis optica spectrum disorder patients compared to healthy controls on all three neuropsychological test scores. This significant difference was observed on the Symbols Digit Modalities Test ( t = 8.875; p ≤ 0.001); California Verbal Learning Test-II memory ( t = 10.418; p ≤ 0.001); and Brief Visuospatial Memory Test Revised ( t = 6.123; p ≤ 0.001). Conclusions This study showed that 70% of neuromyelitis optica spectrum disorder patients exhibited cognitive impairment in two or more cognitive domains. Determining the frequency of cognitive impairment will guide the decision of Neuropsychologists in planning cognitive rehabilitation across various domains.

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“…21,22 Cohort studies identified additional risk factors for long-term disability in NMOSD such as age above 50, a severe first attack and a long interval to correct diagnosis, which can be considered a proxy for delayed treatment initiation. 21,23 However, results are often limited by small sample sizes and/or short follow-up times and often restricted to the early disease phase. Data on patients with MOGAD or those with a NMOSD phenotype but without AQP4-or MOG-IgG antibodies are even more rare.…”

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confidence: 99%

“…Effective treatment in AQP4‐IgG + NMOSD reduces the risk of attacks, but has not unequivocally proven to lower the risk of sustained disability accumulation in short‐term prospective clinical trials 21,22 . Cohort studies identified additional risk factors for long‐term disability in NMOSD such as age above 50, a severe first attack and a long interval to correct diagnosis, which can be considered a proxy for delayed treatment initiation 21,23 . However, results are often limited by small sample sizes and/or short follow‐up times and often restricted to the early disease phase.…”

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confidence: 99%

Time to Disability Milestones and Annualized Relapse Rates in NMOSD and MOGAD

Duchow,

Bellmann‐Strobl,

Friede

et al. 2024

Annals of Neurology

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ObjectiveTo investigate accumulation of disability in neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein‐antibody‐associated disease (MOGAD) in a changing treatment landscape. We aimed to identify risk factors for the development of disability milestones in relation to disease duration, number of attacks, and age.MethodsWe analyzed data from individuals with NMOSD and MOGAD from the German Neuromyelitis Optica Study Group registry. Applying survival analyses, we estimated risk factors and computed time to disability milestones as defined by the EDSS.ResultsWe included 483 patients: 298 AQP4‐IgG+ NMOSD, 52 AQP4‐IgG‐/MOG‐IgG‐ NMOSD patients, and 133 patients with MOGAD. Despite comparable annualized attack rates, disability milestones occurred earlier and after less attacks in NMOSD patients than MOGAD patients (median time to EDSS 3: AQP4‐IgG+ NMOSD 7.7 (95%CI 6.6 – 9.6) years, AQP4‐IgG‐/MOG‐IgG‐ NMOSD 8.7) years, MOGAD 14.1 (95%CI 10.4 – 27.6) years; EDSS 4: 11.9 (95%CI 9.7 – 14.7), 11.6 (95% lower CI 7.6) and 20.4 (95% lower CI 14.1) years; EDSS 6: 20.1 (95%CI 16.5 – 32.1), 20.7 (95% lower CI 11.6), and 37.3 (95% lower CI 29.4) years; and EDSS 7: 34.2 (95% lower CI 31.1) for AQP4‐IgG+ NMOSD). Higher age at onset increased the risk for all disability milestones, while risk of disability decreased over time.InterpretationAQP4‐IgG+ NMOSD, AQP4‐IgG‐/MOG‐IgG‐ NMOSD and MOGAD patients show distinctive relapse‐associated disability progression, with MOGAD having a less severe disease course. Investigator‐initiated research has led to increasing awareness and improved treatment strategies appearing to ameliorate disease outcomes for NMOSD and MOGAD.This article is protected by copyright. All rights reserved.

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Risk factors associated with permanent disability in neuromyelitis optica spectrum disorders

Cited by 7 publications

References 30 publications

Reporte de Caso: Neuromielitis Óptica

Reporte de Caso: Neuromielitis Óptica

Frequency of cognitive impairment in patients with neuromyelitis optica spectrum disorder in Mexico

Time to Disability Milestones and Annualized Relapse Rates in NMOSD and MOGAD

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