Early rituximab treatment reduces long-term disability in aquaporin-4 antibody-positive neuromyelitis optica spectrum
- Authors
- Park, Su Yeon; Kwon, Young Nam; Kim, Sunyoung; Kim, Seung-Hyun; Kim, Jong Kuk; Kim, Jun-Soon; Nam, Tai-Seung; Min, Young Gi; Park, Kyung Seok; Park, Jin-Sung; Seok, Jin Myoung; Sung, Jung-Joon; Sohn, Eunhee; Shin, Kyong Jin; Shin, Jin-Hong; Shin, Ha Young; Oh, Seong-il; Oh, Jeeyoung; Yoon, Byeol-A; Lee, Sanggon; Lee, Jong-Mok; Lee, Hye Lim; Choi, Kyomin; Huh, So-Young; Jang, Myoung-jin; Min, Ju-Hong; Kim, Byoung Joon; Kim, Sung-Min
- Issue Date
- Jun-2023
- Publisher
- BMJ Publishing Group
- Keywords
- NEUROIMMUNOLOGY
- Citation
- Journal of Neurology, Neurosurgery and Psychiatry
- Indexed
- SCIE
SCOPUS
- Journal Title
- Journal of Neurology, Neurosurgery and Psychiatry
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/63520
- DOI
- 10.1136/jnnp-2022-330714
- ISSN
- 0022-3050
1468-330X
- 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.
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Collections - 2. Clinical Science > Department of Neurology > 1. Journal Articles
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