Assessing attacks and treatment response rates among adult patients with NMOSD and MOGAD: Data from a nationwide registry in Argentina
Edgar Carnero Contentti, Pablo A. López, Juan Pablo Pettinicchi, Juan Criniti, Agustín Pappolla, Jimena Míguez, Liliana Patrucco, Edgardo Cristiano, Susana Liwacki, Verónica Tkachuk, María Eugenia Balbuena, Cárlos Vrech, Norma Deri, Jorge Correale, Mariano Marrodán, María Célica Ysrraelit, Felisa Leguizamón, Geraldine Luetic, María Laura Menichini, Darío Tavolini, Carolina Mainella, Gisela Zanga, Marcos Burgos, Javier Hryb, Andrés Barboza, Luciana Lázaro, Ricardo Alonso, Nora Fernández Liguori, Débora Nadur, Aníbal Chertcoff, Marina Alonso Serena, Alejandro Caride, Friedemann Paul, Juan Ignacio Rojas
Abstract
We aimed to examine treatment interventions implemented in patients experiencing neuromyelitis optica spectrum disorders (NMOSD) attacks (frequency, types, and response). METHODS: Retrospective study. Data on patient demographic, clinical and radiological findings, and administered treatments were collected. Remission status (complete [CR], partial [PR], no remission [NR]), based on changes in the EDSS score was evaluated before treatment, during attack, and at 6 months. CR was analyzed with a generalized estimating equations (GEEs) model. RESULTS: A total of 131 patients (120 NMOSD and 11 myelin oligodendrocyte glycoprotein-antibody-associated diseases [MOGAD]), experiencing 262 NMOSD-related attacks and receiving 270 treatments were included. High-dose steroids (81.4%) was the most frequent treatment followed by plasmapheresis (15.5%). CR from attacks was observed in 47% (105/223) of all treated patients. During the first attack, we observed CR:71.2%, PR:16.3% and NR:12.5% after the first course of treatment. For second, third, fourth, and fifth attacks, CR was observed in 31.1%, 10.7%, 27.3%, and 33.3%, respectively. Remission rates were higher for optic neuritis vs. myelitis (p < 0.001). Predictor of CR in multivariate GEE analysis was age in both NMOSD (OR = 2.27, p = 0.002) and MOGAD (OR = 1.53, p = 0.03). CONCLUSIONS: This study suggests individualization of treatment according to age and attack manifestation. The outcome of attacks was generally poor.