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Prognostic Factors Associated with Disability in a Cohort of Neuromyelitis Optica Spectrum Disorder and MOG-Associated Disease from a Nationwide Portuguese Registry.

2024-09-15Text Open access
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dc.contributor.authorMoura, João
dc.contributor.authorSamões, Raquel
dc.contributor.authorSousa, Ana Paula
dc.contributor.authorFigueiroa, Sónia
dc.contributor.authorMendonça, Teresa
dc.contributor.authorAbreu, Pedro
dc.contributor.authorGuimarães, Joana
dc.contributor.authorMelo, Claúdia
dc.contributor.authorSousa, Raquel
dc.contributor.authorSoares, Mafalda
dc.contributor.authorCorreia, Ana Sofia
dc.contributor.authorMarques, Inês Brás
dc.contributor.authorPerdigão, Sandra
dc.contributor.authorAlves, Ivânia
dc.contributor.authorFelgueiras, Helena
dc.contributor.authorNzwalo, Hipólito
dc.contributor.authorMendes, Irene
dc.contributor.authorAlmeida, Vânia
dc.contributor.authorBoleixa, Daniela
dc.contributor.authorCarneiro, Paula
dc.contributor.authorNeves, Esmeralda
dc.contributor.authorSilva, Ana Martins
dc.contributor.authorSá, Maria José
dc.contributor.authorSantos, Ernestina
dc.date.accessioned2025-05-02T15:40:17Z
dc.date.available2025-05-02T15:40:17Z
dc.date.issued2024-09-15
dc.description.abstractIntroduction: Neuromyelitis optica spectrum disorders (NMOSD) and MOG-associated disease (MOGAD) are an increasingly recognized group of demyelinating disorders of the central nervous system. Previous studies suggest that prognosis is predicted by older age at onset, number of relapses, the severity of the first attack and autoantibody status. Objective: To study prognostic factors associated with disability progression and additional relapses in the 3-year follow-up of a national NMOSD/MOGAD cohort. Results: Out of 180 of the initial Portuguese cohort, data on 82 patients was available at the end of the follow-up period (2019-2022). Two patients died. Twenty (24.4%) patients had one or more attack in this period (25 attacks in total), mostly transverse myelitis (TM) (56.0%) or optic neuritis (32.0%). MOGAD was significantly associated with a monophasic disease course (p = 0.03), with milder attacks (p = 0.01), while AQP4 + NMOSD was associated with relapses (p = 0.03). The most common treatment modalities were azathioprine (38.8%) and rituximab (18.8%). AQP4 + NMOSD more frequently required chronic immunosuppressive treatment, particularly rituximab (p = 0.01). Eighteen (22.5%) had an EDSS ≥6 at the end of the follow-up. AQP4 + NMOSD (p < 0.01) and the occurrence of transverse myelitis (TM) during disease (p = 0.04) correlated with an EDSS≥6 at the end of the follow-up period. MOGAD was significantly associated with an EDSS<6 (p < 0.01), and MOG+ cases that reached an EDSS>6 were significantly older (64.0 ± 2.8 versus 31.0 ± 17.1, p = 0.017). A bivariate logistic regression model including the serostatus and TM attacks during disease history successfully predicted 72.2% of patients that progressed to an EDSS≥6. Conclusion: This study highlights that myelitis predict increased disability (EDSS≥6) in NMOSD/MOGAG and AQP4 positivity is associated with increased disability.por
dc.description.abstractThis study highlights that myelitis predict increased disability (EDSS≥6) in NMOSD/MOGAG and AQP4 positivity is associated with increased disability.por
dc.identifier.citationJ Neurol Sci . 2024:464:123176. doi: 10.1016/j.jns.2024.123176.
dc.identifier.doi10.1016/j.jns.2024.123176.
dc.identifier.pmid39146881
dc.identifier.urihttp://hdl.handle.net/10400.17/5085
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectCHLC NEU
dc.subjectAdult
dc.subjectAged
dc.subjectFemale
dc.subjectMale
dc.subjectHumans
dc.subjectMiddle Aged
dc.subjectAquaporin 4 / immunology
dc.subjectAutoantibodies / blood
dc.subjectCohort Studies
dc.subjectDisability Evaluation
dc.subjectDisease Progression
dc.subjectFollow-Up Studies
dc.subjectMyelin-Oligodendrocyte Glycoprotein* / immunology
dc.subjectNeuromyelitis Optica* / epidemiology
dc.subjectPersons with Disabilities
dc.subjectPrognosis
dc.subjectRecurrence
dc.subjectPortugal / epidemiology
dc.subjectYoung Adult
dc.subjectRegistries*
dc.titlePrognostic Factors Associated with Disability in a Cohort of Neuromyelitis Optica Spectrum Disorder and MOG-Associated Disease from a Nationwide Portuguese Registry.eng
dc.typetext
dspace.entity.typePublication
oaire.citation.startPage123176
oaire.citation.titleJournal of the Neurological Sciences
oaire.citation.volume464
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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