Aquaporin-4 serostatus does not predict response to immunotherapy in neuromyelitis optica spectrum disorders

Item Type:	Article
Title:	Aquaporin-4 serostatus does not predict response to immunotherapy in neuromyelitis optica spectrum disorders
Creators Name:	Mealy, M.A. and Kim, S.H. and Schmidt, F. and López, R. and Jimenez Arango, J.A. and Paul, F. and Wingerchuk, D.M. and Greenberg, B.M. and Kim, H.Jin. and Levy, M.
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.
Keywords:	Devic's Disease, Immunosuppression, Relapse, Neuromyelitis Optica, Rituximab, Mycophenolate
Source:	Multiple Sclerosis Journal
ISSN:	1352-4585
Publisher:	Sage Publications
Volume:	24
Number:	13
Page Range:	1737-1742
Date:	1 November 2018
Official Publication:	https://doi.org/10.1177/1352458517730131
External Fulltext:	View full text on PubMed Central
PubMed:	View item in PubMed

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