A multinational team uncovered key factors associated with the long-term course of neuromyelitis optica spectrum disorder (NMOSD) that might help to predict the status of the disease, as published in the Journal of Clinical Medicine.

The authors identified 3 prototypical disease courses based on the change in Expanded Disease Severity Scale (EDSS) scores from baseline to follow-up (about 5 years later): improving, deteriorating, and unchanged. Most (67.2%, n=39) patients in this study cohort improved, while 10.3% (n=6) experienced deterioration. Thirteen (22.4%) patients were classified as unchanged.

“Despite the prototypical illness course, differences between the three groups as regards illness-related and sociodemographic dimensions were modest, suggesting that a highly individualized and tailored treatment regimen appears mandatory,” the authors said.


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Deterioration in patients with NMOSD was associated with a higher total number of attacks at follow-up and a higher progression index. However, the annualized relapse rate was similar between the 3 groups.

The type of NMOSD (ie, seronegative or seropositive) was associated with an unchanged and improving state. Among the patients who improved, there was a lower rate of seronegative cases and a higher rate of seropositive cases. In contrast, the unchanged group had a lower rate of seropositive cases.

Improvement in patients with NMOSD was also associated with the administration of the anti-CD20 monoclonal antibody rituximab. Neither of the disease courses was associated with the annualized relapse rate or the EDSS score at baseline.

Additional factors such as patient’s age, gender, somatic and psychiatric comorbidities, symptoms at disease onset, number and location of cervical plaques, and brain or thoracolumbar plaques at baseline did not differ between groups.

Reference

Sadeghi-Bahmani D, Barzegar M, Mirmosayyeb O, et al. Sociodemographirituc and illness-related indicators to predict the status of neuromyelitis optica spectrum disorder (NMOSD) five years after disease onset. J Clin Med. 2022;11(3):734. doi:10.3390/jcm11030734