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视神经脊髓炎谱系疾病发作的治疗策略和反应:一项真实世界回顾性队列研究。

Treatment strategies and responses for attacks of neuromyelitis optica spectrum disorder: A real-world retrospective cohort study.

机构信息

Neuroimmunology Unit, Department of Neurosciences, Hospital Alemán, Buenos Aires, Argentina.

Neuroimmunology Unit, Department of Neurosciences, Hospital Alemán, Buenos Aires, Argentina.

出版信息

J Neurol Sci. 2024 Jul 15;462:123099. doi: 10.1016/j.jns.2024.123099. Epub 2024 Jun 14.

DOI:10.1016/j.jns.2024.123099
PMID:38897155
Abstract

UNLABELLED

We aimed to assess the treatment strategies utilized in patients with neuromyelitis optica spectrum disorder (NMOSD) experiencing relapses, including their frequency, types, and response after 6 months based on the Expanded Disability Status Scale (EDSS) score.

METHODS

We conducted a retrospective study involving NMOSD patients from the Argentinean MS and NMOSD registry (RelevarEM, NCT03375177). Treatment response at 6 months was categorized as "good" if the EDSS score decreased by ≥1 point after a nadir EDSS score ≤ 3, or by ≥2 points after a nadir EDSS score > 3, "poor" if the EDSS score decrease was slighter, and as "absent" if the EDSS score remained unchanged or worsened.

RESULTS

We included 120 NMOSD patients (seropositive N = 75), who experienced 250 NMOSD-related relapses and received 248 treatments. At 6 months, complete recovery was achieved in 70/98 (71.4%) and 15/19 (79%) patients, respectively. Predictors of a "good" response in our regression model were a younger age at disease onset (OR:3.54, CI95% 2.45-5.01, p < 0.0001) and a short delay from onset of relapse to treatment initiation (OR:1.56, CI95% 1.22-2.13, p = 0.004).

CONCLUSIONS

Approximately two-thirds of patients experienced complete recovery, and younger age and a short delay to start treatment were independent predictors of a "good" response.

摘要

目的

根据扩展残疾状况量表(EDSS)评分,评估视神经脊髓炎谱系疾病(NMOSD)患者复发时使用的治疗策略,包括其频率、类型和 6 个月后的反应。

方法

我们进行了一项回顾性研究,纳入了来自阿根廷多发性硬化症和 NMOSD 登记处(RelevarEM,NCT03375177)的 NMOSD 患者。6 个月时的治疗反应分为“良好”,如果 EDSS 评分在最低 EDSS 评分≤3 后下降≥1 分,或在最低 EDSS 评分>3 后下降≥2 分;“差”为 EDSS 评分下降更轻微;“无”为 EDSS 评分不变或恶化。

结果

我们纳入了 120 名 NMOSD 患者(血清阳性 N=75),他们经历了 250 次 NMOSD 相关复发,并接受了 248 次治疗。在 6 个月时,98 例中的 70 例(71.4%)和 19 例中的 15 例(79%)完全恢复。在我们的回归模型中,“良好”反应的预测因素为发病年龄较小(OR:3.54,95%CI95%2.45-5.01,p<0.0001)和复发到开始治疗的时间较短(OR:1.56,95%CI95%1.22-2.13,p=0.004)。

结论

大约三分之二的患者完全恢复,年龄较小和开始治疗的时间较短是“良好”反应的独立预测因素。

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