Clinical phenotype and treatment response in AQP4-IgG-positive NMOSD and MOGAD: insights from the Italian I-MS&RD registry.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Tortorella Carla, Cruciani Alessandro, Patti Francesco, Capobianco Marco, Iaffaldano Pietro, Mirabella Massimiliano, Inglese Matilde, Pastò Luisa, Haggiag Shalom, Prosperini Luca, Ruggieri Serena, Fantozzi Roberta, Foschi Matteo, De Luca Giovanna, Vianello Marika, Salemi Giuseppe, Montepietra Sara, Ferraro Diana, Cavalla Paola, Maniscalco Giorgia Teresa, Curti Erica, Lugaresi Alessandra, Marfia Girolama Alessandra, Valentino Paola, Di Sapio Alessia, Frau Jessica, Realmuto Sabrina, Cottone Salvatore, Rocca Maria A, Colombo Elena, Perini Paola, Crisafulli Sebastiano, Ferrò Maria Teresa, Romano Silvia, Protti Alessandra, Landi Anna Chiara, Coniglio Maria Gabriella, Annovazzi Pietro, Pasquali Livia, Ferraro Elisabetta, Pesci Ilaria, Peresson Marco, Lanzillo Roberta, Totaro Rocco, Lus Giacomo, Bova Stefania Maria, Cantello Roberto, Zuliani Luigi, Cargnelutti Daniela, Massacesi Luca, Bonaventura Ardito, Trotta Maria, Gajofatto Alberto, Aguglia Umberto, Santuccio Giuseppe, Danni Maura Chiara, Burlina Alessandro, Clerici Raffaella, Gazzola Paola, Bucello Sebastiano, Pizzorno Matteo, Barone Paolo, Conte Antonella, Santangelo Giuseppe, Marinelli Fabiana, Avolio Carlo, Leone Alessandro, Rossi Francesca, Frigo Maura, Mascoli Nerina, Carrozzi Marco, Buccafusca Maria, Sica Francesco, Rini Augusto, Falcini Mario, Ribizzi Giuseppe, Bartolozzi Maria Letizia, Gasperini Claudio, Trojano Maria, Filippi Massimo, Amato Maria Pia, Italian MS Register
Аннотация
METHODS: We identified 664 patients from 97 Italian centres: 406 with AQP4+ NMOSD and 258 with MOGAD. Demographic, clinical, and treatment characteristics were compared between groups. Time to first relapse was assessed according to treatment class, comparing monoclonal antibodies with other therapies. Predictors of relapse-free status were evaluated using multivariable logistic regression.
RESULTS: Female sex was more common in AQP4+ NMOSD than in MOGAD patients (p < 0.001), whereas paediatric onset was more common in MOGAD (p < 0.001). Patients with AQP4+ NMOSD had greater disability at diagnosis than patients with MOGAD (p < 0.001). Rituximab was the most prescribed therapy. Treatment with monoclonal antibodies was associated with longer relapse-free survival in AQP4+ NMOSD (log-rank p = 0.021), but not in MOGAD. In AQP4+ NMOSD patients treated with rituximab, male sex and myelitis at onset were independently associated with a lower likelihood of remaining relapse-free (OR 0.37, 95% CI 0.14-0.94; p = 0.038 and OR 0.36, 95% CI 0.15-0.83; p = 0.017, respectively). In contrast, among rituximab-treated patients with MOGAD, optic neuritis at onset was the only predictor of relapse-free status at follow-up (OR 0.20, 95% CI 0.04-0.90; p = 0.038).
CONCLUSIONS: This nationwide, large-scale analysis, derived from the newly established I-MS&RD Registry, characterises a large Italian cohort of patients with AQP4+ NMOSD and MOGAD, identifies clinically relevant predictors of response to rituximab, and provides real-world evidence on treatment-associated relapse outcomes in these two disorders.