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- Title
Aquaporin-4 serostatus does not predict response to immunotherapy in neuromyelitis optica spectrum disorders.
- Authors
Mealy, Maureen A.; Kim, Su-Hyun; Schmidt, Felix; López, Reydmar; Jimenez Arango, Jorge A.; Paul, Friedemann; Wingerchuk, Dean M.; Greenberg, Benjamin M.; Kim, Ho Jin; Levy, Michael
- 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.
- Subjects
NEUROMYELITIS optica; CNS demyelinating autoimmune diseases; IMMUNOTHERAPY; AQUAPORINS; MEMBRANE proteins
- Publication
Multiple Sclerosis Journal, 2018, Vol 24, Issue 13, p1737
- ISSN
1352-4585
- Publication type
Article
- DOI
10.1177/1352458517730131