Risk of relapse in patients with neuromyelitis optica spectrum disorder: Recognition and preventive strategy

Ma, Xiaoyu; Kermode, Allan G.; Hu, Xueqiang; Qiu, Wei

doi:10.1016/j.msard.2020.102522

Cited by 40 publications

(73 citation statements)

References 118 publications

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“…The risks, however, need to be balanced against the risks of COVID-19 itself, leading to morbidity and death even in people without disabilities. Moreover, numerous data is demonstrating a higher risk of more severe COVID-19 course in patients with MS and NMOSD treated with high-dose glucocorticoids or anti-CD20 monoclonal antibodies ( Barzegar et al., 2021a ; Prosperini et al., 2022 ; Stastna et al., 2021 ) and there are also data showing an association between systemic infection and risk of MS or NMOSD relapse ( Correale et al., 2006 ; Ma et al., 2020 ).…”

Section: Introductionmentioning

confidence: 99%

To be or not to be vaccinated: The risk of MS or NMOSD relapse after COVID-19 vaccination and infection

Stastna

Menkyová

Drahota

et al. 2022

Multiple Sclerosis and Related Disorders

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Section: Introductionmentioning

confidence: 99%

To be or not to be vaccinated: The risk of MS or NMOSD relapse after COVID-19 vaccination and infection

Stastna

Menkyová

Drahota

et al. 2022

Multiple Sclerosis and Related Disorders

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“…Thus, the EDSS scores of 4.0 and 6.0 are regarded as key milestones in disability (Harding et al, 2019) and irreversible disability. Relapse is defined as new-onset, progressive, or recurrent neurological symptoms caused by NMOSD that last longer than 24 hours and results in an increase of at least 0.5 points on the EDSS, an increase of at least 1 on two functional system (FS) scales, an increase of at least 2 on one FS scale, or new lesions on magnetic resonance imaging (MRI) (Fujihara, 2019;Ma et al, 2020). The information regarding the time from the NMOSD onset to the study endpoint (irreversible disability and relapse) was analyzed.…”

Section: Clinical Data Collectionmentioning

confidence: 99%

Clinical significance of anti-SSA/Ro antibody in Neuromyelitis optica spectrum disorders

Lin

Hang

Zhang

et al. 2022

Multiple Sclerosis and Related Disorders

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…The onset age of NMOSD is an important factor that can affect the disease relapse and severity ( 4 , 5 ). Previous studies have reported that the rates of disability and mortality are different among early-onset NMOSD (EO-NMOSD <50 years at onset), late-onset NMOSD (LO-NMOSD, 50–70 years at onset), and very late-onset NMOSD (VLO-NMOSD, >70 years at onset) ( 5 – 9 ).…”

Section: Introductionmentioning

confidence: 99%

Relatively Early and Late-Onset Neuromyelitis Optica Spectrum Disorder in Central China: Clinical Characteristics and Prognostic Features

Yan

Niu

et al. 2022

Front. Neurol.

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BackgroundWe aimed to analyze the clinical characteristics and prognostic features of Chinese patients with relatively late-onset neuromyelitis optica spectrum disorder (RLO-NMOSD>40 years of age at disease onset), compared with patients with relatively early onset NMOSD (REO-NMOSD, ≤ 40 years of age at disease onset).MethodsWe retrospectively reviewed the medical records of patients with NMOSD in central China (with disease courses longer than 3 years) between January 2012 and January 2021. We further analyzed the clinical and prognostic differences between patients with REO-NMOSD and RLO-NMOSD.ResultsA total of 71 patients were included in this study. The results showed that 39 (54.9%) of the patients had RLO-NMOSD. The patients with RLO-NMOSD had higher expanded disability status scale (EDSS) scores than patients with REO-NMOSD at the initial (5.0 vs. 3.0, p = 0.01), 3-month (4.0 vs. 2.5, p = 0.001), 1-year (4.0 vs. 2.5, p = 0.003), 3rd-year (3.5 vs. 3.0, p = 0.0017), and final follow-up (4.0 vs. 2.5, P = 0.002) time points. The EDSS scores of visual function were 2.0 (1.0–3.0) in REO-NMOSD and 3.0 (2.0–3.0) in RLO-NMOSD (p = 0.038) at the final follow-up time point. The locations of spinal cord lesions at transverse myelitis (TM) onset were prone to cervical cord in patients with REO-NMOSD. There were no between-group treatment differences. The risk of requiring a cane to walk (EDSS score of 6.0) increased as the age of disease onset increased: for every 10-year increase in the age of disease onset, the risk of needing a cane to walk increased by 65% [hazard ratio (HR) = 1.65, 95% CI 1.15–2.38, p = 0.007]. Another significant predictor identified in the multivariate analysis was annualized relapse rate (ARR) (HR = 2.01, 95% CI 1.09–3.71, p = 0.025). In addition, we observed a positive correlation between age at onset and EDSS scores at the final follow-up (Spearman's r = 0.426, p < 0.0001) time point. EDSS scores at different periods were significantly different between patients with RLO-NMOSD and REO-NMOSD with anti-aquaporin-4 (AQP4) IgG positive.ConclusionThe patients with RLO-NMOSD developed more severe disabilities than patients with REO-NMOSD at a variety of time periods. All of the patients may experience recurrent aggravated symptoms after their first year, with only patients with REO-NMOSD partly recovering from the 3rd year. The age at onset and ARR were the main predictors of outcomes.

show abstract

Risk of relapse in patients with neuromyelitis optica spectrum disorder: Recognition and preventive strategy

Cited by 40 publications

References 118 publications

To be or not to be vaccinated: The risk of MS or NMOSD relapse after COVID-19 vaccination and infection

To be or not to be vaccinated: The risk of MS or NMOSD relapse after COVID-19 vaccination and infection

Clinical significance of anti-SSA/Ro antibody in Neuromyelitis optica spectrum disorders

Relatively Early and Late-Onset Neuromyelitis Optica Spectrum Disorder in Central China: Clinical Characteristics and Prognostic Features

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