Efficacy and safety of azathioprine, mycophenolate mofetil, and reduced dose of rituximab in neuromyelitis optica spectrum disorder

doi:10.1111/ene.15355

科研成果详情

题名	Efficacy and safety of azathioprine, mycophenolate mofetil, and reduced dose of rituximab in neuromyelitis optica spectrum disorder
作者	Huang, Wenjuan 1,2,3; Wang, Liang 1,2,3; Xia, Junhui4; Li, Wenyu 5; Wang, Min 6; Yu, Jian 6; Li, Qinying 7; Wang, Bei 8; Pan, Juyuan4; Du, Lei 9; Ma, Jianhua 9; Tan, Hongmei 1,2,3; Chang, Xuechun 1,2,3; Lu, Chuanzhen 1,2,3; Zhao, Chongbo 1,2,3; Lu, Jiahong 1,2,3; Zhou, Lei 1,2,3; ZhangBao, Jingzi 1,2,3; Quan, Chao 1,2,3
发表日期	2022-08
发表期刊	EUROPEAN JOURNAL OF NEUROLOGY 影响因子和分区
语种	英语
原始文献类型	Article ; Early Access
关键词	aquaporin 4 azathioprine mycophenolate mofetil neuromyelitis optica spectrum disorder rituximab
其他关键词	MYELIN-OLIGODENDROCYTE GLYCOPROTEIN ; DOUBLE-BLIND ; AQUAPORIN-4 ; MULTICENTER ; TOLERABILITY ; SATRALIZUMAB ; MARKER
摘要	Background and purpose Data regarding the efficacy and safety of currently widely available preventive therapies in neuromyelitis optica spectrum disorder (NMOSD) are needed. We compared the efficacy and safety of azathioprine (AZA), mycophenolate mofetil (MMF), and reduced dose of rituximab (RTX) in NMOSD based on a large multicenter retrospective cohort. Methods Patients with aquaporin 4 (AQP4) antibody-positive NMOSD with AZA (n = 167), MMF (n = 131), or RTX (n = 55) as initial preventive treatment were included. The main outcome was the occurrence of relapse after the initiation of immunotherapy. Secondary outcomes were annual relapse rate, disability accumulation, drug persistence, and adverse events. Results The median follow-up time of the 353 patients was 30.3 months. The regimen of RTX was 100 mg on Day 1 and 500 mg on Day 2, followed by 500 mg every 6 months. The proportions of patients with concomitant steroid therapy at baseline were 96.4%, 95.4%, and 76.4% in the AZA, MMF, and RTX groups. Risk of relapse was significantly reduced in patients treated with RTX compared with those treated with AZA (hazard ratio [HR] = 4.40, 95% confidence interval [CI] = 1.41-13.80, p = 0.011) or MMF (HR = 5.20, 95% CI = 1.60-16.86, p = 0.006) after adjusting for potential confounding variables. Drug discontinuations were less likely on RTX than AZA (HR = 2.22, 95% CI = 1.34-3.66, p = 0.002). RTX exhibited lower incidence of adverse events (32.7%) than AZA (62.3%, p < 0.001). Conclusions We provide Class III evidence that reduced dose of RTX is superior to AZA and MMF as initial treatment to reduce the risk of relapse and is better tolerated than AZA in Chinese patients with AQP4 antibody-positive NMOSD.
资助项目	National Natural Science Foundation of China [82171341]; Shanghai Municipal Science and Technology Major Project [2018SHZDZX01]; Zhangjiang Lab; National Key Research and Development Program of China [2016YFC0901504]
出版者	WILEY
出版地	HOBOKEN
ISSN	1351-5101
EISSN	1468-1331
卷号	29 期号:8 页码:2343-2354
DOI	10.1111/ene.15355
页数	12
WOS类目	Clinical Neurology ; Neurosciences
WOS研究方向	Neurosciences & Neurology
WOS记录号	WOS:000787787400001
收录类别	SCIE ; SCOPUS ; PUBMED
URL	查看原文
PubMed ID	35398950
SCOPUSEID	2-s2.0-85133954910
通讯作者地址	[ZhangBao, Jingzi]Department of Neurology,Huashan Hospital,Shanghai Medical College,Fudan University,Shanghai,China ; [Quan, Chao]Department of Neurology,Huashan Hospital,Shanghai Medical College,Fudan University,Shanghai,China
Scopus学科分类	Neurology;Neurology (clinical)
引用统计	被引频次[WOS]：0 [WOS记录] [WOS相关记录]
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/148148
专题	附属第一医院
通讯作者	ZhangBao, Jingzi; Quan, Chao
作者单位	1.Department of Neurology,Huashan Hospital,Shanghai Medical College,Fudan University,Shanghai,China; 2.National Center for Neurological Disorders,Shanghai,China; 3.Huashan Rare Disease Center,Huashan Hospital,Shanghai Medical College,Fudan University,Shanghai,China; 4.Department of Neurology,First Affiliated Hospital of Wenzhou Medical University,Wenzhou,China; 5.Department of Neurology,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou,China; 6.Department of Ophthalmology and Vision Science,Eye and ENT Hospital,Fudan University,Shanghai,China; 7.Department of Rehabilitation Medicine,Jing'an District Center Hospital of Shanghai,Fudan University,Shanghai,China; 8.Department of Neurology,Jing'an District Center Hospital of Shanghai,Fudan University,Shanghai,China; 9.Department of Neurology,First Affiliated Hospital of Xinjiang Medical University,Urumqi,China
推荐引用方式 GB/T 7714	Huang, Wenjuan,Wang, Liang,Xia, Junhui,et al. Efficacy and safety of azathioprine, mycophenolate mofetil, and reduced dose of rituximab in neuromyelitis optica spectrum disorder[J]. EUROPEAN JOURNAL OF NEUROLOGY,2022,29(8):2343-2354.
APA	Huang, Wenjuan., Wang, Liang., Xia, Junhui., Li, Wenyu., Wang, Min., ... & Quan, Chao. (2022). Efficacy and safety of azathioprine, mycophenolate mofetil, and reduced dose of rituximab in neuromyelitis optica spectrum disorder. EUROPEAN JOURNAL OF NEUROLOGY, 29(8), 2343-2354.
MLA	Huang, Wenjuan,et al."Efficacy and safety of azathioprine, mycophenolate mofetil, and reduced dose of rituximab in neuromyelitis optica spectrum disorder".EUROPEAN JOURNAL OF NEUROLOGY 29.8(2022):2343-2354.