Clinical insights and risk factors for disability in aquaporin-4-IgG-positive neuromyelitis optica spectrum disorder patients: a multicenter real-world study in Greece.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Akrivaki Alexandra, Tzanetakos Dimitrios, Gkotzamanis Viktor, Tsogka Anthi, Bakirtzis Christos, Dimitriadou Evangelia Makrina, Theodorou Aikaterini, Pechlivanidou Maria, Papakonstantinou Aliki, Skarlatou Vasiliki, Kitsos Dimitrios, Stella Marousi, Roussos Fotios, Georgopoulou Efstratia-Maria, Kaliontzoglou Anastasia, Karathanasis Dimitris, Xylogiannopoulou Stavroula, Markakis Ioannis, Plomaritis Panagiotis, Stasinaki Polyxeni, Karamatzianni Georgia, Papantoniou Michail, Tagaris George, Gryllia Maria, Angelidakis Panagiotis, Doskas Triantafyllos, Mastorodemos Vasileios, Notas Konstantinos, Boziki Marina, Kostadima Vasiliki, Ellul John, Chroni Elisabeth, Mitsias Panayiotis, Evangelopoulos Maria-Eleptheria, Konitsiotis Spyridon, Dardiotis Efthimios, Iliopoulos Ioannis, Fakas Nikolaos, Voumvourakis Konstantinos, Koutsouraki Effrosyni, Kimiskidis Vasilios K, Giannopoulos Sotirios, Grigoriadis Nikolaos, Tsivgoulis Georgios, Tzartos John
Аннотация
METHODS: A retrospective analysis of medical records from 93 anti-AQP4 seropositive NMOSD patients, diagnosed according to the 2015 International Panel criteria and followed between 2001-2024 in 16 Neurological Departments, was conducted. Data on demographics, clinical features, disease courses, autoimmune comorbidities, and treatment responses were analyzed.
RESULTS: We identified 93 Caucasian patients (95.7% female), with a mean age at NMOSD onset of 45.6 (±18) years and a mean disease duration of 9.8 (±8.2) years. The most common 1st attack manifestations were transverse myelitis (45.2%) and optic neuritis (32.2%). Autoimmune comorbidities were observed in 32.2% of patients. Age at onset correlated with the clinical phenotype of the 1st attack; myelitis was more frequent in older patients, whereas optic neuritis was more common in younger patients. During follow-up, 55.9% experienced relapses, and the median Expanded Disability Status Scale (EDSS) score was 3. Prophylactic treatment was administered to 89% of patients, with rituximab being the most common therapy. In multivariable logistic regression models older age at disease onset (odds ratio [OR]: 1.069; 95%CI:1.031-1.08, p<0.001), longer disease duration (OR: 1.129; 95%CI:1.022-1.248, p=0.017), and switching between multiple treatments (OR: 2.105; 95%CI:1.029-4.304, p=0.041), were associated with a higher likelihood of severe disability (EDSS ≥4).
CONCLUSIONS: This study highlights an age-related trend in NMOSD presentations and identifies key predictors of disability. Individualized treatment strategies, particularly for older patients, are essential for optimizing disease management.