Prevalence of Progression Independent of Relapse Activity and Relapse-Associated Worsening in Patients With Aqp4-Igg-Positive Nmosd Publisher Pubmed



Siriratnam P¹ ; Huda S¹ ; Van Der Walt A¹ ; Sanfilippo PG¹ ; Sharmin S¹ ; Foong YC¹ ; Yeh WZ¹ ; Zhu C¹ ; Khoury SJ¹ ; Csepany T¹ ; Willekens B¹ ; Etemadifar M¹ ; Ozakbas S¹ ; Nytrova P¹ Show All Authors Show Affiliations
Source: Neurology Published:2024

Abstract

OBJECTIVES: In aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4-IgG NMOSD), disability accrual is mostly attributed to relapses. This study aimed to assess the prevalence of progression independent of relapse activity (PIRA) and relapse-associated worsening (RAW) in AQP4-IgG NMOSD. METHODS: This was a retrospective cohort study of patients with AQP4-IgG NMOSD enrolled in the MSBase international data registry. Patients required a minimum of 3 recorded Expanded Disability Status Scale (EDSS) scores: baseline, event, and a 6-month confirmation score. Presence and absence of relapses between the baseline and event EDSS scores determined RAW and PIRA, respectively. Descriptive statistics were used to present the results. RESULTS: A total of 181 patients followed for a median of 4.5 years (Q1 1.7, Q3 7.8) were included. Most patients were female (88.4%), and the median age at disease onset was 38.1 years. Overall, 4 patients (2.2%) developed 5 incidences of PIRA and 13 patients developed RAW (7.2%). DISCUSSION: This multicenter study highlights that PIRA is very rare in AQP4-IgG NMOSD. Limitations of this study include the sole focus of overall EDSS to measure disability, lack of requirement for a second EDSS score to confirm baseline EDSS, and the absence of magnetic resonance imaging information for all patients.