视神经脊髓炎谱系障碍的更新诊断标准：既往不同队列的相似结果
Updated diagnostic criteria for neuromyelitis optica spectrum disorder: Similar outcomes of previously separate cohorts.
作者信息
McCreary M, Mealy M A, Wingerchuk D M, Levy M, DeSena A, Greenberg B M
机构信息
Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, USA.
Department of Neurology, Johns Hopkins Hospital, USA.
出版信息
Mult Scler J Exp Transl Clin. 2018 Dec 6;4(4):2055217318815925. doi: 10.1177/2055217318815925. eCollection 2018 Oct-Dec.
BACKGROUND
The specificity of the aquaporin-4 antibody to predict recurrent inflammatory central nervous system disease has led to the design of the 2015 neuromyelitis optica spectrum disorder criteria which capture all aquaporin-4 antibody seropositive patients.
OBJECTIVE
The purpose of this study was to compare treatment outcomes in aquaporin-4 antibody seropositive patients who met the previous 2006 clinical criteria for neuromyelitis optica with patients who meet the 2015 neuromyelitis optica spectrum disorder criteria.
METHODS
The study involved a three-center retrospective chart review of clinical outcomes among aquaporin-4 patients diagnosed with neuromyelitis optica and neuromyelitis optica spectrum disorder.
RESULTS
Hazard ratios of relapse during immunosuppressive therapy, relative to pre-therapy, were not significantly different for patients who met the 2006 criteria of neuromyelitis optica versus the 2015 neuromyelitis optica spectrum disorder criteria among those treated with azathioprine ( = 0.24), mycophenolate mofetil ( = 0.63), or rituximab ( = 0.97).
CONCLUSION
Reductions in the hazard of relapse during treatment with immunosuppressive therapies, relative to average pre-treatment, were not different for aquaporin-4 antibody seropositive patients categorized using the 2006 criteria of neuromyelitis optica and the 2015 neuromyelitis optica spectrum disorder criteria. These therapeutic findings support the design of the 2015 neuromyelitis optica spectrum disorder criteria which capture all aquaporin-4 antibody seropositive patients.
背景
水通道蛋白4抗体预测复发性炎性中枢神经系统疾病的特异性促使了2015年视神经脊髓炎谱系障碍标准的制定，该标准涵盖了所有水通道蛋白4抗体血清阳性患者。
目的
本研究旨在比较符合2006年视神经脊髓炎临床标准的水通道蛋白4抗体血清阳性患者与符合2015年视神经脊髓炎谱系障碍标准的患者的治疗结果。
方法
该研究涉及对诊断为视神经脊髓炎和视神经脊髓炎谱系障碍的水通道蛋白4患者的临床结局进行三中心回顾性病历审查。
结果
在接受硫唑嘌呤（=0.24）、霉酚酸酯（=0.63）或利妥昔单抗（=0.97）治疗的患者中，符合2006年视神经脊髓炎标准的患者与符合2015年视神经脊髓炎谱系障碍标准的患者相比，免疫抑制治疗期间相对于治疗前的复发风险比率无显著差异。
结论
对于根据2006年视神经脊髓炎标准和2015年视神经脊髓炎谱系障碍标准分类的水通道蛋白4抗体血清阳性患者，免疫抑制治疗期间相对于平均治疗前的复发风险降低并无差异。这些治疗结果支持了2015年视神经脊髓炎谱系障碍标准的制定，该标准涵盖了所有水通道蛋白4抗体血清阳性患者。
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