Department of Neurology, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan; Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang-Gung University, Linkou, Taoyuan, Taiwan; Graduate Institute of Mind, Brain, & Consciousness, Taipei Medical University, Taipei, Taiwan.
Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang-Gung University, Linkou, Taoyuan, Taiwan; Institute of Molecular Medicine, National Tsing Hua University, Hsinchu, Taiwan.
Mult Scler Relat Disord. 2024 Jul;87:105683. doi: 10.1016/j.msard.2024.105683. Epub 2024 May 11.
Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune inflammatory demyelinating disease characterized by relapsing clinical episodes and the presence of autoantibodies. The impact of comorbidities on relapsing rate of NMOSD patients in Taiwan remains unclear.
We conducted a longitudinal retrospective study using the largest hospital system in Taiwan from 2006 to 2021. Demographic characteristics, annualized relapse rates (ARR), and comorbidities were examined.
We identified 485 NMOSD patients from 2006 to 2021. Of these, 466 had the adult form and 19 (3.9 %) had the pediatric form of NMOSD. The median ARR was 0.51 (interquartile range (IQR): 0.26-1.11) for adults and 0.39 (IQR: 0.21-0.77) for pediatric patients. Comorbidities included malignancy (6.7 %) and autoimmune diseases (21.7 %). The recommended age for malignancy surveillance in NMOSD patients was 43.3 years. Neither malignancy nor autoimmune disease increased the ARR within 3 years post diagnosis in NMOSD patients with comorbidities compared with those without comorbidities.
Our study revealed the ARR within the initial three years after diagnosis was significantly higher, emphasizing the importance of early treatment. We also observed an association between malignancy and NMOSD, and a significantly higher risk of malignancy in adult patients with NMOSD than in the general population (the relative risk was 5.99) that requiring further investigations into the underlying mechanisms. These findings contribute to a better understanding of NMOSD and its comorbidities in Taiwan.
视神经脊髓炎谱系疾病（NMOSD）是一种自身免疫性炎症性脱髓鞘疾病，其特征为反复发作的临床发作和自身抗体的存在。合并症对台湾 NMOSD 患者复发率的影响尚不清楚。
我们进行了一项使用台湾最大医院系统的纵向回顾性研究，时间范围为 2006 年至 2021 年。研究考察了人口统计学特征、年化复发率（ARR）和合并症。
我们从 2006 年至 2021 年共确定了 485 例 NMOSD 患者。其中 466 例为成人型，19 例（3.9%）为儿童型 NMOSD。成人的平均 ARR 为 0.51（四分位距（IQR）：0.26-1.11），儿童为 0.39（IQR：0.21-0.77）。合并症包括恶性肿瘤（6.7%）和自身免疫性疾病（21.7%）。NMOSD 患者恶性肿瘤监测的推荐年龄为 43.3 岁。与无合并症的 NMOSD 患者相比，在诊断后 3 年内，合并恶性肿瘤或自身免疫性疾病并未增加 NMOSD 患者的 ARR。
本研究显示，诊断后最初三年内的 ARR 显著较高，强调了早期治疗的重要性。我们还观察到恶性肿瘤与 NMOSD 之间存在关联，NMOSD 成年患者的恶性肿瘤风险显著高于一般人群（相对风险为 5.99），需要进一步研究其潜在机制。这些发现有助于更好地了解台湾的 NMOSD 及其合并症。
