血清AQP4抗体阳性视神经脊髓炎患者的高效治疗-一项现实世界研究

IF 3.9 2区医学 Q1 CLINICAL NEUROLOGY

Annals of Clinical and Translational Neurology Pub Date : 2025-07-02 DOI:10.1002/acn3.70128

Xiang Li, Binbin Xue, Jia Li, Dewei Xie, Juyuan Pan, Lanbing Zhu, Qiaowen Tong, Jing Lin, Xu Zhang, Junhui Xia, Jie Lin

{"title":"血清AQP4抗体阳性视神经脊髓炎患者的高效治疗-一项现实世界研究","authors":"Xiang Li, Binbin Xue, Jia Li, Dewei Xie, Juyuan Pan, Lanbing Zhu, Qiaowen Tong, Jing Lin, Xu Zhang, Junhui Xia, Jie Lin","doi":"10.1002/acn3.70128","DOIUrl":null,"url":null,"abstract":"Objective: To compare the effectiveness of high-efficacy treatments (HET) and low-efficacy treatments (LET) in NMOSD patients with anti-aquaporin-4 antibodies (AQP4-ab).Methods: In this multi-center study, we analyzed 183 AQP4-ab seropositive NMOSD patients who received immunosuppressive treatments (IST). Primary outcomes included annualized relapse rate (ARR) and Expanded Disability Status Scale (EDSS).Results: A total of 86 HET and 143 LET treatment episodes were included. Patients with HET had the lower relapse rate (41.9% vs. 59.4%, p = 0.015). At the final follow-up, the HET group had lower ARR (p = 0.003) and EDSS (p = 0.004) compared to LET. HET (p < 0.001, adjusted p < 0.001), early IST initiation after onset (p = 0.007, adjusted p = 0.008) and younger age of onset (p = 0.024, adjusted p = 0.028) were the protective factors for high EDSS, and HET (HR: 0.66, 95% CI: 0.44-0.99, p = 0.047) prolonged the remission after IST. Meantime, Anderson-Gill analysis indicated that HET is associated with a lower risk of relapse (p < 0.001). After PSM, patients receiving HET had significantly reduced ARR (p = 0.046) and EDSS scores (p =0.030) compared to those receiving LET.Interpretation: Our findings indicated the superior efficacy in reducing neurological disability and relapse risk of HET in AQP4-ab seropositive NMOSD patients.","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":" ","pages":""},"PeriodicalIF":3.9000,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"High-Efficacy Treatment in Neuromyelitis Optica Specturm Disorder Patients With Seropositive AQP4 Antibodies-A Real-World Study.\",\"authors\":\"Xiang Li, Binbin Xue, Jia Li, Dewei Xie, Juyuan Pan, Lanbing Zhu, Qiaowen Tong, Jing Lin, Xu Zhang, Junhui Xia, Jie Lin\",\"doi\":\"10.1002/acn3.70128\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective: To compare the effectiveness of high-efficacy treatments (HET) and low-efficacy treatments (LET) in NMOSD patients with anti-aquaporin-4 antibodies (AQP4-ab).Methods: In this multi-center study, we analyzed 183 AQP4-ab seropositive NMOSD patients who received immunosuppressive treatments (IST). Primary outcomes included annualized relapse rate (ARR) and Expanded Disability Status Scale (EDSS).Results: A total of 86 HET and 143 LET treatment episodes were included. Patients with HET had the lower relapse rate (41.9% vs. 59.4%, p = 0.015). At the final follow-up, the HET group had lower ARR (p = 0.003) and EDSS (p = 0.004) compared to LET. HET (p < 0.001, adjusted p < 0.001), early IST initiation after onset (p = 0.007, adjusted p = 0.008) and younger age of onset (p = 0.024, adjusted p = 0.028) were the protective factors for high EDSS, and HET (HR: 0.66, 95% CI: 0.44-0.99, p = 0.047) prolonged the remission after IST. Meantime, Anderson-Gill analysis indicated that HET is associated with a lower risk of relapse (p < 0.001). After PSM, patients receiving HET had significantly reduced ARR (p = 0.046) and EDSS scores (p =0.030) compared to those receiving LET.Interpretation: Our findings indicated the superior efficacy in reducing neurological disability and relapse risk of HET in AQP4-ab seropositive NMOSD patients.\",\"PeriodicalId\":126,\"journal\":{\"name\":\"Annals of Clinical and Translational Neurology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2025-07-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Clinical and Translational Neurology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/acn3.70128\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Clinical and Translational Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/acn3.70128","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目的：比较抗水通道蛋白-4抗体（AQP4-ab） NMOSD患者高效治疗（HET）与低效治疗（LET）的疗效。方法：在这项多中心研究中，我们分析了183例接受免疫抑制治疗（IST）的AQP4-ab血清阳性NMOSD患者。主要结局包括年复发率（ARR）和扩展残疾状态量表（EDSS）。结果：共纳入86例HET和143例LET治疗。HET患者复发率较低（41.9% vs. 59.4%, p = 0.015）。在最后随访时，与LET组相比，HET组的ARR （p = 0.003）和EDSS （p = 0.004）较低。解释：我们的研究结果表明，在AQP4-ab血清阳性的NMOSD患者中，HET在降低神经功能障碍和复发风险方面具有优越的疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

High-Efficacy Treatment in Neuromyelitis Optica Specturm Disorder Patients With Seropositive AQP4 Antibodies-A Real-World Study.

Objective: To compare the effectiveness of high-efficacy treatments (HET) and low-efficacy treatments (LET) in NMOSD patients with anti-aquaporin-4 antibodies (AQP4-ab).

Methods: In this multi-center study, we analyzed 183 AQP4-ab seropositive NMOSD patients who received immunosuppressive treatments (IST). Primary outcomes included annualized relapse rate (ARR) and Expanded Disability Status Scale (EDSS).

Results: A total of 86 HET and 143 LET treatment episodes were included. Patients with HET had the lower relapse rate (41.9% vs. 59.4%, p = 0.015). At the final follow-up, the HET group had lower ARR (p = 0.003) and EDSS (p = 0.004) compared to LET. HET (p < 0.001, adjusted p < 0.001), early IST initiation after onset (p = 0.007, adjusted p = 0.008) and younger age of onset (p = 0.024, adjusted p = 0.028) were the protective factors for high EDSS, and HET (HR: 0.66, 95% CI: 0.44-0.99, p = 0.047) prolonged the remission after IST. Meantime, Anderson-Gill analysis indicated that HET is associated with a lower risk of relapse (p < 0.001). After PSM, patients receiving HET had significantly reduced ARR (p = 0.046) and EDSS scores (p =0.030) compared to those receiving LET.

Interpretation: Our findings indicated the superior efficacy in reducing neurological disability and relapse risk of HET in AQP4-ab seropositive NMOSD patients.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Annals of Clinical and Translational Neurology Medicine-Neurology (clinical)

CiteScore

9.10

自引率

1.90%

发文量

218

审稿时长

8 weeks

期刊介绍： Annals of Clinical and Translational Neurology is a peer-reviewed journal for rapid dissemination of high-quality research related to all areas of neurology. The journal publishes original research and scholarly reviews focused on the mechanisms and treatments of diseases of the nervous system; high-impact topics in neurologic education; and other topics of interest to the clinical neuroscience community.