Please use this identifier to cite or link to this item: https://hdl.handle.net/20.500.14365/5558
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dc.contributor.authorSiriratnam, Pakeeran-
dc.contributor.authorSanfilippo, Paul-
dc.contributor.authorvan der Walt, Anneke-
dc.contributor.authorSharmin, Sifat-
dc.contributor.authorFoong, Yi Chao-
dc.contributor.authorYeh, Wei Zhen-
dc.contributor.authorZhu, Chao-
dc.date.accessioned2024-10-25T15:17:49Z-
dc.date.available2024-10-25T15:17:49Z-
dc.date.issued2024-
dc.identifier.issn0022-3050-
dc.identifier.issn1468-330X-
dc.identifier.urihttps://doi.org/10.1136/jnnp-2024-334090-
dc.identifier.urihttps://hdl.handle.net/20.500.14365/5558-
dc.description.abstractBackground Neuromyelitis optica spectrum disorder (NMOSD) can be categorised into aquaporin-4 antibody (AQP4-IgG) NMOSD or seronegative NMOSD. While our knowledge of AQP4-IgG NMOSD has evolved significantly in the past decade, seronegative NMOSD remains less understood. This study aimed to evaluate the predictors of relapses and treatment responses in AQP4-IgG NMOSD and seronegative NMOSD. Methods This was a multicentre, international, retrospective cohort study using the MSBase registry. Recurrent relapse risk was assessed using an Andersen-Gill model and risk of first relapse was evaluated using a Cox proportional hazards model. Covariates that putatively influence relapse risk included demographic factors, clinical characteristics and immunosuppressive therapies; the latter was assessed as a time-varying covariate. Results A total of 398 patients (246 AQP4-IgG NMOSD and 152 seronegative NMOSD) were included. The AQP4-IgG NMOSD and seronegative NMOSD patients did not significantly differ by age at disease onset, ethnicity or annualised relapse rate. Both low-efficacy and high-efficacy immunosuppressive therapies were associated with significant reductions in recurrent relapse risk, with notably greater protection conferred by high-efficacy therapies in both AQP4-IgG NMOSD (HR 0.27, 95% CI 0.15 to 0.49, p<0.001) and seronegative NMOSD (HR 0.21, 95% CI 0.08 to 0.51, p<0.001). Longer disease duration (HR 0.97, 95% CI 0.95 to 0.99, p<0.001) and male sex (HR 0.52, 95% CI 0.34 to 0.84, p=0.007) were additional protective variables in reducing the recurrent relapse risk for the AQP4-IgG NMOSD group. Conclusion Although further studies are needed to improve our understanding of seronegative NMOSD, our findings underscore the importance of aggressive treatment with high-efficacy immunotherapies in both NMOSD subtypes, regardless of serostatus.en_US
dc.language.isoenen_US
dc.publisherBmj Publishing Groupen_US
dc.relation.ispartofJournal of neurology neurosurgery and psychiatryen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectMULTIPLE SCLEROSISen_US
dc.subjectNEUROIMMUNOLOGYen_US
dc.subjectIMMUNOLOGYen_US
dc.subjectMEDICINEen_US
dc.subjectHEALTH ECONOMICSen_US
dc.subjectOptica Spectrum Disorderen_US
dc.subjectNeuromyelitis-Opticaen_US
dc.subjectDouble-Blinden_US
dc.subjectEfficacyen_US
dc.subjectSafetyen_US
dc.subjectAzathioprineen_US
dc.subjectSatralizumaben_US
dc.subjectRituximaben_US
dc.subjectOutcomesen_US
dc.titlePredictors of relapse risk and treatment response in AQP4-IgG positive and seronegative NMOSD: A multicentre studyen_US
dc.typeArticleen_US
dc.typeArticle; Early Accessen_US
dc.identifier.doi10.1136/jnnp-2024-334090-
dc.identifier.pmid39231582en_US
dc.identifier.scopus2-s2.0-85204235831en_US
dc.departmentİzmir Ekonomi Üniversitesien_US
dc.authoridSiriratnam, Pakeeran/0000-0003-4751-2102-
dc.authoridFoschi, Matteo/0000-0002-0321-7155-
dc.authorwosidFoschi, Matteo/ABR-7231-2022-
dc.authorwosidSiriratnam, Pakeeran/AGX-6343-2022-
dc.authorwosidMonif, Mastura/L-4124-2019-
dc.authorwosidSoysal, Aysun/AAX-7696-2021-
dc.authorscopusid57210635745-
dc.authorscopusid6701687565-
dc.authorscopusid35079672200-
dc.authorscopusid55028512500-
dc.authorscopusid55258457800-
dc.authorscopusid57201885527-
dc.authorscopusid57348355200-
dc.identifier.wosWOS:001309611300001en_US
dc.institutionauthor-
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.cerifentitytypePublications-
item.cerifentitytypePublications-
item.openairetypeArticle-
item.openairetypeArticle; Early Access-
item.languageiso639-1en-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
Appears in Collections:PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection
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