Binbin Xue
*
Junhui Xia
*
Jie Lin
*The final, formatted version of the article will be published soon.
ORIGINAL RESEARCH article
Front. Immunol.
Sec. Multiple Sclerosis and Neuroimmunology
Volume 15 - 2024 |
doi: 10.3389/fimmu.2024.1458556
This article is part of the Research Topic Neuroinfection-Related Immunity and Inflammation View all 5 articles
Effects of Early Intervention in Neuromyelitis Optica Spectrum Disorder Patients with Seropositive AQP4 antibodies
Provisionally accepted- First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Background: The impact of early intervention with immunosuppressive treatment (IST) in anti-Aquaporin4-antibody (AQP4-ab) seropositive neuromyelitis optica spectrum disorder (NMOSD) has not been thoroughly evaluated. Objective: This study aims to assess the effects of early IST intervention in patients with NMOSD. Methods: This retrospective cohort study included 174 treatments from 137 NMOSD patients seropositive for AQP4-antibody, treated with ISTs such as rituximab, mycophenolate mofetil, azathioprine, or tacrolimus. Multiple statistical analyses, including regression discontinuity design (RDD), kaplan-meier analyse, Cox proportional hazards regression model, were employed to evaluate the effects of early IST intervention on annualized relapse rate (ARR) change, Expanded Disability Status Scale (EDSS) change, and time to next relapse. Results: A total of 174 treatments from 137 patients were analyzed. Patients exhibited significant improvement in ARR[1.95 vs.0 , IQR (0.70-6.0 vs. 0-0.42) , p<0.001] and EDSS [3.0 vs. 2.5, IQR (2.0-4.0 vs. 1.0-3.0) p<0.001]after IST, although the ARR change was not significant in patients treated with TAC. Early IST initiation was associated with greater improvements in both ARR and EDSS compared to later initiation. RDD analysis demonstrated a time-dependent effect of ARR-change, indicating greater efficacy with early IST intervention. Conclusions: Early intervention with ISTs in AQP4-antibody-positive NMOSD patients is associated with better outcomes in terms of reducing relapse rate and improving disability. These findings underscore the the importance of early treatment in NMOSD.
Keywords: Neuromyelitis optica spectrum disorder, AQP4-antibody, Early Intervention, immunosuppressive treatments, Annualized relapse rate, EDSS
Received: 02 Jul 2024; Accepted: 17 Oct 2024.
Copyright: © 2024 Xue, Li, Xie, Weng, Zhang, Li, Xia and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Binbin Xue, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Jia Li, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Dewei Xie, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Yiyun Weng, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Xu Zhang, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Xiang Li, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Junhui Xia, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
Jie Lin, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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