Early rituximab treatment reduces long-term disability in aquaporin-4 antibody-positive neuromyelitis optica spectrum
- Abstract
- Background: Neuromyelitis optica spectrum disorder (NMOSD) causes relapsing inflammatory attacks in the central nervous system, leading to disability. As rituximab, a B-lymphocyte-depleting monoclonal antibody, is an effective in preventing NMOSD relapses, we hypothesised that earlier initiation of rituximab can also reduce long-term disability of patients with NMOSD.
Methods: This multicentre retrospective study involving 19 South Korean referral centres included patients with NMOSD with aquaporin-4 antibodies receiving rituximab treatment. Factors associated with the long-term Expanded Disability Status Scale (EDSS) were assessed using multivariable regression analysis.
Results: In total, 145 patients with rituximab treatment (mean age of onset, 39.5 years; 88.3% female; 98.6% on immunosuppressants/oral steroids before rituximab treatment; mean disease duration of 121 months) were included. Multivariable analysis revealed that the EDSS at the last follow-up was associated with time to rituximab initiation (interval from first symptom onset to initiation of rituximab treatment). EDSS at the last follow-up was also associated with maximum EDSS before rituximab treatment. In subgroup analysis, the time to initiation of rituximab was associated with EDSS at last follow-up in patients aged less than 50 years, female and those with a maximum EDSS score ≥6 before rituximab treatment.
Conclusions: Earlier initiation of rituximab treatment may prevent long-term disability worsening in patients with NMOSD, especially among those with early to middle-age onset, female sex and severe attacks.
- All Author(s)
- Su Yeon Park
; Young Nam Kwon
; Sunyoung Kim
; Seung-Hyun Kim
; Jong Kuk Kim
; Jun-Soon Kim
; Tai-Seung Nam
; Young Gi Min
; Kyung Seok Park
; Jin-Sung Park
; Jin Myoung Seok
; Jung-Joon Sung
; Eunhee Sohn
; Kyong Jin Shin
; Jin-Hong Shin
; Ha Young Shin
; Seong-Il Oh
; Jeeyoung Oh
; Byeol-A Yoon
; Sanggon Lee
; Jong-Mok Lee
; Hye Lim Lee
; Kyomin Choi
; So-Young Huh
; Myoung-Jin Jang
; Ju-Hong Min
; Byoung Joon Kim
; Sung-Min Kim
- Issued Date
- 2023
- Type
- Article
- Keyword
- NEUROIMMUNOLOGY
- Publisher
- British Medical Association
- ISSN
- 0022-3050
; 1468-330X
- Citation Title
- Journal of neurology, neurosurgery, and psychiatry
- Citation Volume
- 94
- Citation Number
- 10
- Citation Start Page
- 800
- Citation End Page
- 805
- Language(ISO)
- eng
- DOI
- 10.1136/jnnp-2022-330714
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/3394
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