Multiple sclerosis and related disorders最新文献

{"title":"A comparative study of gait pattern characteristics between individuals with multiple sclerosis and healthy individuals during anticipatory postural adjustment and gait initiation: A scoping review","authors":"Narges Jahantigh Akbari ,&nbsp;Fatemeh Ehsani ,&nbsp;Marzieh Mortezaejad ,&nbsp;Mohammad Yousefi ,&nbsp;Khorshid Bijari","doi":"10.1016/j.msard.2025.106949","DOIUrl":"10.1016/j.msard.2025.106949","url":null,"abstract":"<div><div>Individuals diagnosed with multiple sclerosis (MS) are known to face more challenging situations, such as gait initiation (GI), compared to healthy individuals. This provides a deeper insight into the mechanisms that govern dynamic postural control. A search was conducted across several databases, including PubMed, Cochrane, ScienceDirect, Web of Science, Scopus, ProQuest, and Google Scholar. Studies of any design were included if they satisfied the following criteria: the experimental group consisted of individuals with MS or clinically isolated syndrome, the control group included healthy individuals or MS patients, and the studies examined gait patterns across various parameters, such as the center of pressure (COP), center of mass, and anticipatory postural adjustments, while also assessing the gait initiation phase. Utilizing the modified Downs and Black checklist, nine articles were selected for the final analysis. The results indicated deceleration, a reduction in posterior COP displacement, and an increase in COP during anterior GI. Compared with healthy controls, individuals with MS exhibited greater instability during balance recovery and in kinetic parameters of the stance limb. Furthermore, a delay and reduction in muscle activity were noted in individuals with MS who had a history of falls, in contrast to non-falling MS patients and healthy individuals.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106949"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145940036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early determinants of long-term outcomes in multiple sclerosis","authors":"Ozan Dörtkol,&nbsp;Ahmed Serkan Emekli,&nbsp;Edis Hacılar,&nbsp;Sevda Öztürk Erden,&nbsp;Tuncay Gündüz,&nbsp;Murat Kürtüncü","doi":"10.1016/j.msard.2025.106964","DOIUrl":"10.1016/j.msard.2025.106964","url":null,"abstract":"<div><h3>Background</h3><div>Multiple sclerosis (MS) exhibits remarkable heterogeneity in its clinical course, yet the determinants of long-term disability progression remain incompletely understood. Identifying demographic and clinical predictors of unfavorable trajectories is essential for individualized management.</div></div><div><h3>Objective</h3><div>To investigate demographic, clinical, and laboratory factors influencing disability progression and relapse dynamics in a large Turkish MS cohort with over two decades of follow-up.</div></div><div><h3>Methods</h3><div>This retrospective study included 1580 patients diagnosed with MS according to the 2017 McDonald criteria and followed between 1980 and 2020. Data on demographic, clinical, and laboratory parameters were analyzed. Survival analyses assessed time to expanded disability status scale (EDSS) 3 and 6 milestones, and logistic regression identified predictors of progressive disease.</div></div><div><h3>Results</h3><div>The cohort comprised 1092 females and 488 males (mean follow-up: 7.5 ± 5.7 years). Male sex and lower educational attainment were associated with faster disability accumulation (log-rank, <em>p</em> &lt; 0.005 and <em>p</em> &lt; 0.001, respectively). Motor, cerebellar, and spinal onset were significant predictors of a progressive phenotype, while optic neuritis, sensory, and brainstem onset indicated a relapsing–remitting course. Neither smoking, family history, nor oligoclonal band (OCB) positivity influenced disability progression. Inter-relapse intervals shortened until the fifth relapse, thereafter stabilizing, marking a potential inflection point in inflammatory activity.</div></div><div><h3>Conclusion</h3><div>This long-term cohort highlights distinct demographic and clinical predictors of MS progression. Early disability accumulation, particularly before reaching EDSS 3, appears critical in determining long-term outcomes. These findings emphasize the importance of early, aggressive therapeutic intervention within the initial disease phase to alter the trajectory of MS progression.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106964"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life, productivity loss, and mental health service utilization among parents of children with neuroinflammatory disorders: A cross-sectional study","authors":"Ramesh Lamsal ,&nbsp;E. Ann Yeh ,&nbsp;Eleanor Pullenayegum ,&nbsp;Wendy J. Ungar","doi":"10.1016/j.msard.2026.107032","DOIUrl":"10.1016/j.msard.2026.107032","url":null,"abstract":"<div><h3>Background</h3><div>Children with neuroinflammatory disorders (NDs) require caregiving, affecting parental health and employment. This study assessed parents’ productivity losses, mental health services use, health-related quality of life (HRQoL), and care-related QoL.</div></div><div><h3>Methods</h3><div>This cross-sectional study enrolled children with NDs and parents at a single center. Data on productivity losses and mental health services use for both parents were collected. Respondent parents’ HRQoL and care-related QoL were measured using Health Utilities Index (HUI3) and Care-related Quality of Life (CarerQol) instrument. HUI3 scores were compared to Canadian parental norms. Annual parental costs per two-parent household and societal costs were estimated.</div></div><div><h3>Results</h3><div>Forty-seven parent-child dyads participated. Mean ages were 43.76 (SD 6.31) years for respondent parents and 12.00 (SD 3.34) years for children. Work and/or usual activity disruptions were reported by 86 % (31/36) of respondent parents and 78 % (28/36) of partners. Twenty-two percent (8/36) of respondent parents and 8 % (3/36) of partners used mental health services due to caregiving stress. Median (IQR) annual household costs for parents and society were CAD 2,767.87 (1,414.78–7,894.43). Mann-Whitney U test revealed no statistical difference in HUI-3 scores between parents of children with NDs (<em>n</em> = 46, median:0.93) and Canadian population parental norms (<em>n</em> = 2,799, median:0.93), <em>W</em> = 426434, <em>p</em> = 0.13. Mean CarerQol-7D and VAS scores were 85.97 (SD11.94) and 7.68 (SD1.08), respectively.</div></div><div><h3>Conclusion</h3><div>Parents of children with NDs reported work and/or daily activity disruptions and household costs; their HRQoL was comparable to Canadian parental norms. Larger studies with comparison groups of parents of healthy children are needed to confirm these findings.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107032"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a machine learning model to predict the expanded disability status scale in multiple sclerosis patients","authors":"Asiye Tuba Ozdogar ,&nbsp;Murat Emec ,&nbsp;Ergi Kaya ,&nbsp;Ela Simay Zengin ,&nbsp;Mehmet Hilal Ozcanhan ,&nbsp;Serkan Ozakbas","doi":"10.1016/j.msard.2025.106937","DOIUrl":"10.1016/j.msard.2025.106937","url":null,"abstract":"<div><h3>Objective</h3><div>The assessment of disability in multiple sclerosis (MS) patients is crucial for treatment decisions and prognosis estimation. The Expanded Disability Status Scale (EDSS) provides a standardized way to quantify disability in MS. However, predicting EDSS scores can be challenging due to the complex and heterogeneous nature of the disease. Machine learning techniques offer a promising approach to predict EDSS scores based on various patient characteristics.</div></div><div><h3>Methods</h3><div>231 people with MS (pwMS) who had an assessment of physical, psychosocial, and cognitive functions in three timelines (baseline (T0), first year (T1), and second year (T2)) were enrolled. The dataset used for the study consists of 126 features. Feature selection was based on feature saliency and correlation analysis. Three machine learning models —XGBoost, Random Forest, and Linear Regression —were trained on the selected features. Hyperparameter tuning was also carried out on the models. Model performance was evaluated using standard evaluation metrics, including MAE, MSE, and R².</div></div><div><h3>Results</h3><div>The Machine Learning model based on the XGBoost algorithm performed best in predicting EDSS scores (T2). The MAE value obtained with the XGBoost model is 0.2361, the MSE value is 0.2408, and the R2 value is 0.9705. These results indicate that XGBoost's predictive ability on the current dataset is promising.</div></div><div><h3>Conclusion</h3><div>Our study demonstrates the feasibility of using machine learning techniques to predict EDSS scores in MS patients. The developed models show promising performance and have the potential to enhance clinical decision-making and patient management in MS care.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106937"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SPHERES: innovative registry addressing the new era of neuromyelitis optica spectrum disorders (NMOSD) therapy","authors":"Jeffrey L. Bennett ,&nbsp;Nicole Middaugh ,&nbsp;Michael R. Yeaman ,&nbsp;Terry J. Smith ,&nbsp;Megan K. Behne ,&nbsp;Margaux Crabtree ,&nbsp;Robert R. McLean ,&nbsp;Dimitros A. Pappas ,&nbsp;Michael Levy","doi":"10.1016/j.msard.2025.106940","DOIUrl":"10.1016/j.msard.2025.106940","url":null,"abstract":"<div><div>Neuromyelitis Optica Spectrum Disorders (NMOSD) are rare, autoimmune disorders of the central nervous system (CNS) that affect optic nerves and spinal cord. The SPHERES (Synergy of Prospective Health &amp; Experimental Research for Emerging Solutions) Registry for NMOSD, a prospective observational cohort of adult patients in the United States, established in June 2021, was designed to gather robust and high-quality longitudinal data to facilitate knowledge of NMOSD and better understand the newly approved therapeutics. The objective of this study was to detail the SPHERES Registry features and characterize the SPHERES population in aggregate and stratified by serostatus at registry enrollment. Registry questionnaires were completed by clinicians and patients at enrollment and at routine clinical visits occurring at ∼6-month intervals, with additional data collection between visits. At enrollment into SPHERES, mean age of the first 350 patients enrolled was 50.1 years, 84 % of the cohort was female, 66 % had anti-AQP4+ NMOSD, and 71 % reported use of a biologic therapy. A number of demographic and disease characteristics and disease activity measures varied by serostatus, including mean durations since symptom onset and diagnosis and mean EDSS score. Patient-reported outcome measures were generally similar across serostatus groups. This analysis of the initial SPHERES patients provides valuable insights into the ability of the Registry to capture the natural history, real-world effectiveness, therapeutic utilization and safety in treating NMOSD.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106940"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple sclerosis and uveitis: Clinical characteristics and prognosis","authors":"William GIL ,&nbsp;Samuel CHACUN ,&nbsp;Géraldine ANDRODIAS ,&nbsp;Caroline VASSENEIX ,&nbsp;Laurent KODJIKIAN ,&nbsp;Sandra VUKUSIC ,&nbsp;Pascal SÈVE ,&nbsp;Thomas EL-JAMMAL","doi":"10.1016/j.msard.2026.107047","DOIUrl":"10.1016/j.msard.2026.107047","url":null,"abstract":"<div><h3>Background</h3><div>The neurological prognosis of multiple sclerosis (MS) varies across clinical patterns but remains unclear when associated with uveitis.</div></div><div><h3>Objective</h3><div>To investigate the neurological prognosis and clinical characteristics of MS-associated uveitis compared with MS without uveitis.</div></div><div><h3>Methods</h3><div>We conducted a retrospective case-control study including 35 patients with MS-associated uveitis and 102 matched MS controls (1:3; age, sex, MS course). Clinical and neurological data were extracted from the Lyon Cohort Uveitis and the EDMUS database. The primary endpoint was the difference in Expanded Disability Status Scale (EDSS) between baseline and last follow-up.</div></div><div><h3>Results</h3><div>Patients with MS-associated uveitis were more often of North African origin than controls (48.6 % vs 20.6 %, <em>p</em> = 0.006; OR 3.51, 95 % CI [1.41–8.77]). Median follow-up was 19 years [14–26] in the uveitis group and 16 years [13–22] in controls. Baseline EDSS was comparable between groups (2.0 vs 2.0), as was EDSS at last follow-up (3.0 vs 3.0). However, patients aged &gt;32 years with MS-associated uveitis had a significantly lower risk of disability progression compared with controls.</div></div><div><h3>Conclusions</h3><div>MS-associated uveitis was more frequent in patients of North African origin and often showed a sarcoidosis-like phenotype. In patients older than 32 years, it was associated with a more favorable neurological outcome.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107047"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world evidence of clinical outcomes and adherence to ofatumumab in the UK and the impact of a patients support programme: A retrospective, non-interventional cohort study","authors":"David Paling ,&nbsp;David Cottrell ,&nbsp;Ruth Hamlin ,&nbsp;Colin O’Leary ,&nbsp;Owen Pearson ,&nbsp;Agne Straukiene ,&nbsp;Pyry Kivi ,&nbsp;Wendy Rice ,&nbsp;Sarah Al-Azki ,&nbsp;Nazanin Kondori","doi":"10.1016/j.msard.2026.107030","DOIUrl":"10.1016/j.msard.2026.107030","url":null,"abstract":"<div><h3>Background</h3><div>Ofatumumab is the only anti-CD20 monoclonal antibody disease modifying therapy available for self- administration for adults with active relapsing remitting multiple sclerosis (RMS). This study aimed to investigate real-world adherence and clinical outcomes of ofatumumab-treated patients in the UK and looked at the impact of a patient support program called Kesimpta Connect (KC PSP) on these outcomes.</div></div><div><h3>Methods</h3><div>This retrospective observational cohort study examined adherence to ofatumumab in 155 RMS patients recruited from six UK MS centres. The primary objective of the study was to describe the medication possession ratio (MPR) adherence of ofatumumab treated patients over a 13-month period. The study also looked at clinical effectiveness measures, including change in annualized relapse rates (ARR). Safety and secondary-care use was also assessed in this study.</div></div><div><h3>Results</h3><div>103 patients had data available to be assessed for adherence and clinical effectiveness. 87 % (n=90) of patients had an MPR adherence of 0.80 or greater and higher proportion of non-KC PSP users reported adherence of greater than 0.80 than KC PSP users (98.4 % vs 69.2 %). The total ARR decreased during the follow-up period from 0.33 (95 % CI 0.23-0.40) prior to ofatumumab initiation to 0.06 (95 % CI 0.01-0.11) 12-months after initiation. In terms of safety, 38.1 % (n=59/155) patients reported experiencing an adverse event during the follow-up period; one was reported to be severe. However, no patients reported discontinuing ofatumumab during the study follow-up period.</div></div><div><h3>Conclusion</h3><div>This study provides evidence of good adherence for RMS patients using ofatumumab. Further, there is evidence of clinical effectiveness based on reduction in ARR post-ofatumumab initiation, as well as tolerability and a favourable safety profile. The results of this study support the continued use of ofatumumab in providing effective RMS disease management in the UK NHS.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107030"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-infusion observation of patients with multiple sclerosis receiving natalizumab: Is it necessary?","authors":"Melika Arab Bafrani,&nbsp;Negar Sadat Ahmadi,&nbsp;Fateme Zahra Idjadi,&nbsp;Sanaz Bordbar,&nbsp;Shima Jahani,&nbsp;Rayhane Montazeri,&nbsp;Sara Kamali Zonouzi,&nbsp;Mahsa Mohammadi Lapevandani,&nbsp;Zahra Ebadi,&nbsp;Samira Navardi,&nbsp;Hora Heidari,&nbsp;Amirreza Azimi,&nbsp;Abdorreza Naser Moghadasi,&nbsp;Mohammad Ali Sahraian","doi":"10.1016/j.msard.2026.106995","DOIUrl":"10.1016/j.msard.2026.106995","url":null,"abstract":"<div><h3>Background/Objective</h3><div>Natalizumab (Tysabri ®), the first monoclonal antibody approved for treatment of relapsing-remitting Multiple Sclerosis (RRMS), can significantly reduce exacerbations and active brain lesions. Due to concerns on infusion-related reactions (IRRs) patients should be observed during the infusions and one hour after the completion of the infusions for signs and symptoms of hypersensitivity reactions, especially in the first 12 doses. This study was conducted to see if one-hour post-infusion observation is necessary in all patients receiving natalizumab or can be wavied in some stable patients.</div></div><div><h3>Method</h3><div>In this cross-sectional study, one-hour post-infusion observation was not conducted in patients who had previously received three doses of natalizumab without any history of moderate to severe or life-threatening IRRs based on the Common Terminology Criteria for Adverse Events (CTCAE) definition. Patient demographics and clinical characteristics were recorded by a trained physician in a questionnaire coupled with an emergency hotline provided for IRRs. In case of a modere to sever or life-threatening reaction during the ifusion the patient excluded from the study. Phone follow-up was done after an hour by the same medical doctor.</div></div><div><h3>Result</h3><div>424 patients with MS were enrolled in this study. Fatigue (10.8%), headache (4.5%), and cough (2.8%) were the most prevalent symptoms after 1 hour from the infusions. No life-threatening complications happened for the patients. There was no significant relationship between age, gender, the interval between doses, the number of total infusions, and disease duration with the incidence of side effects.</div></div><div><h3>Conclusion</h3><div>Early discharge without one hour post-infusion monitoring can be considered for patients without any moderate to sever adverse reaction in the fisrt three infusion of natalizumab.This sterategy may reduce the costs and save the time of infusion for these patients.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 106995"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incident and prevalent peripartum mental illness in mothers with multiple sclerosis and other chronic diseases in Sweden","authors":"Ruth Ann Marrie ,&nbsp;Colleen J Maxwell ,&nbsp;James M. Bolton ,&nbsp;Jonas Söderling ,&nbsp;Charles N Bernstein ,&nbsp;Kristen M Krysko ,&nbsp;Kyla A McKay ,&nbsp;Dalia Rotstein ,&nbsp;Karma Deakin-Harb ,&nbsp;Neda Razaz","doi":"10.1016/j.msard.2026.107041","DOIUrl":"10.1016/j.msard.2026.107041","url":null,"abstract":"<div><h3>Background</h3><div>Findings conflict regarding the risk of peripartum mental illness in women with multiple sclerosis (MS) and how this compares to the risk among women with other chronic diseases. We compared the incidence and prevalence of peripartum mental illness among women with MS, epilepsy, inflammatory bowel disease (IBD), diabetes, and women without any of these diseases (comparators).</div></div><div><h3>Methods</h3><div>Using population-based Swedish administrative health data we selected women with MS, epilepsy, IBD, diabetes, and comparators who had deliveries between 2002 and 2019. Using validated case definitions for peripartum mental illness we estimated the incidence and prevalence of mental illness during the period encompassing pregnancy and the first post-partum year. We compared incidence and prevalence between cohorts using crude estimates and unadjusted Poisson regression.</div></div><div><h3>Results</h3><div>We included 1096,814 women (1936 MS; 7709 epilepsy; 7731 IBD; 7182 diabetes; 1072,256 comparators). Mean (SD) age at conception was 30.1 (5.1) years. Compared to comparators, mothers with MS had a higher incidence of any mental illness (incidence rate ratio [IRR] 1.36; 1.04–1.78), as did mothers with epilepsy (1.78; 1.58–2.00), IBD (1.46; 1.28–1.66) and diabetes (1.61; 1.41–1.83). Mothers with MS, epilepsy, IBD and diabetes also had a higher incidence and prevalence of depression and bipolar disorder than comparators. Mothers with epilepsy had higher incidence rates of anxiety, and higher prevalence ratios of any mental illness and anxiety than mothers with MS.</div></div><div><h3>Conclusions</h3><div>Women with MS, epilepsy, IBD and diabetes have a similarly elevated incidence and prevalence of peripartum mental illness as compared to mothers without these conditions.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107041"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline severe disability as a predictor of treatment escalation to rituximab in AQP4-IgG–positive NMOSD patients: A retrospective cohort study","authors":"Chayangkoon Siripornmongkol,&nbsp;Metha Apiwattanakul,&nbsp;Saharat Aungsumart","doi":"10.1016/j.msard.2026.107022","DOIUrl":"10.1016/j.msard.2026.107022","url":null,"abstract":"<div><h3>Introduction</h3><div>Azathioprine and mycophenolate mofetil remain widely used as first-line immunosuppressive therapies for neuromyelitis optica spectrum disorder (NMOSD) in resource-limited settings. However, a subset of patients experience ongoing disease activity or treatment intolerance requiring escalation to rituximab. Identification of clinical factors associated with treatment escalation may improve treatment strategies.</div></div><div><h3>Objectives</h3><div>To identify clinical factors associated with escalation from azathioprine and mycophenolate mofetil to rituximab in AQP4-IgG–positive NMOSD patients.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of AQP4-IgG–positive NMOSD patients treated at the Neurological Institute of Thailand between 2019 and 2024. Patients initially treated with azathioprine or mycophenolate mofetil were followed until escalation to rituximab or last follow-up. Baseline demographic, clinical, and laboratory variables were analyzed using logistic regression to identify factors associated with treatment escalation.</div></div><div><h3>Results</h3><div>Among 173 patients, 35 (20.23%) required escalation to rituximab. In multivariable analysis, baseline severe disability (EDSS ≥6 prior to first-line therapy) was independently strongly associated with treatment escalation to rituximab (OR 18.19, 95% CI 2.22–148.95; p=0.007). Other demographic and laboratory variables were not independently associated.</div></div><div><h3>Conclusion</h3><div>Baseline severe disability was strongly associated with subsequent escalation to rituximab. Early identification of high-risk patients may support more individualized treatment strategies and inform future policy decisions in resource-limited healthcare systems.</div></div>","PeriodicalId":18958,"journal":{"name":"Multiple sclerosis and related disorders","volume":"107 ","pages":"Article 107022"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146034515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}