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Mult Scler. 2018 Nov;24(13):1737-1742. doi: 10.1177/1352458517730131. Epub 2017 Aug 31.

Aquaporin-4 serostatus does not predict response to immunotherapy in neuromyelitis optica spectrum disorders.

Author information

1
The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
2
Research Institute and Hospital of National Cancer Center, Goyang, Korea.
3
Charité University Medicine and Max Delbrück Center for Molecular Medicine, Berlin, Germany.
4
Neuroclinica, Medellín, Colombia.
5
Mayo Clinic, Scottsdale, AZ, USA.
6
The University of Texas Southwestern Medical Center, Dallas, TX, USA.

Abstract

BACKGROUND:

Debate exists about whether neuromyelitis optica spectrum disorder seronegative disease represents the same immune-mediated attack on astrocytic aquaporin-4 as in seropositive disease.

OBJECTIVE:

We investigated whether response to common treatments for neuromyelitis optica spectrum disorder differed by serostatus, as assessed by change in annualized relapse rate.

METHODS:

We performed a multicenter retrospective analysis of 245 patients with neuromyelitis optica spectrum disorder who were treated with either rituximab or mycophenolate mofetil as their first-line immunosuppressive treatment for disease prevention. Patients were followed for a minimum of 6 months following treatment initiation.

RESULTS:

In those started on rituximab, the pre-treatment annualized relapse rates for seropositive and seronegative patients were 1.81 and 1.93, respectively. On-treatment annualized relapse rates significantly declined to 0.32 (seropositive; p < 0.0001) and 0.12 (seronegative; p = 0.0001). In those started on mycophenolate mofetil, the pre-treatment annualized relapse rates for seropositive and seronegative patients were 1.79 and 1.45, respectively. On-treatment annualized relapse rates declined to 0.29 (seropositive; p < 0.0001) and 0.30 (seronegative; p < 0.005).

CONCLUSION:

In this international collaboration involving a large number of neuromyelitis optica spectrum disorder patients, treatment was effective regardless of serostatus. This suggests that treatment should not differ when considering these treatments.

KEYWORDS:

Devic’s disease; immunosuppression; mycophenolate; neuromyelitis optica; relapse; rituximab

PMID:
28857723
PMCID:
PMC5794637
[Available on 2019-11-01]
DOI:
10.1177/1352458517730131

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