Neuromyelitis Optica Spectrum Disorder With Anti-Aquaporin-4 Antibody: Outcome Prediction Models

doi:10.3389/fimmu.2022.873576

科研成果详情

题名	Neuromyelitis Optica Spectrum Disorder With Anti-Aquaporin-4 Antibody: Outcome Prediction Models
作者	Wang, Liang 1,2; Du, Lei 3; Li, Qinying 4; Li, Fang 2,5; Wang, Bei 6; Zhao, Yuanqi 7; Meng, Qiang 8; Li, Wenyu 9; Pan, Juyuan10; Xia, Junhui10; Wu, Shitao 11; Yang, Jie 12; Li, Heng 13; Ma, Jianhua 3; ZhangBao, Jingzi 1,2; Huang, Wenjuan 1,2; Chang, Xuechun 1,2; Tan, Hongmei 1,2; Yu, Jian 14; Zhou, Lei 1,2; Lu, Chuanzhen 1,2; Wang, Min 14; Dong, Qiang 1,2; Lu, Jiahong 1,2; Zhao, Chongbo 1,2; Quan, Chao 1,2
发表日期	2022-03-31
发表期刊	FRONTIERS IN IMMUNOLOGY 影响因子和分区
语种	英语
原始文献类型	Article
关键词	neuromyelitis optica spectrum disorder anti-aquaporin-4 antibody maintenance therapy outcome prediction model
其他关键词	DOUBLE-BLIND ; EFFICACY ; MULTICENTER ; SATRALIZUMAB ; AQUAPORIN-4 ; THERAPY ; SAFETY
摘要	BackgroundRecognizing the predictors of disease relapses in patients with anti-aquaporin-4 antibody (AQP4-ab)-positive neuromyelitis optica spectrum disorder (NMOSD) is essential for individualized treatment strategy. We aimed to identify the factors that predicted relapses among patients with AQP4-ab-positive NMOSD, develop outcome prediction models, and validate them in a multicenter validation cohort. MethodsBetween January 2015 and December 2020, 820 patients with NMOSD were registered at Huashan Hospital. We retrospectively reviewed their medical records, and included 358 AQP4-ab-positive patients with 1135 treatment episodes. Univariate and multivariate analyses were used to explore the predictors of relapse, severe visual or motor disability during follow-up. A model predicting the 1- and 2-year relapse-free probability was developed and validated in an external validation cohort of 92 patients with 213 treatment episodes. ResultsLower serum AQP4-ab titer (< 1:100), higher Expanded Disability Status Scale (EDSS) score at onset (>= 2.5), and use of intravenous methylprednisolone (IVMP) at the first attack predicted an overall lower annualized relapse rate. Older age (> 48 years), optic neuritis at onset, and higher onset EDSS score (>= 2.5) significantly increased the risk for blindness, while IVMP at the first attack and maintenance therapy reduced the risk for blindness. Myelitis at onset increased the possibility of motor disability (EDSS >= 6.0), severe motor disability or death (EDSS >= 8.0), while maintenance therapy reduced these possibilities. Anderson and Gill model identified that the risk factors predicting recurrent relapses under certain treatment status were female gender, high AQP4-ab titer (>= 1:100), previous attack under same therapy, lower EDSS score at treatment initiation (< 2.5), and no maintenance therapy or oral prednisone lasting less than 6 months. A nomogram using the above factors showed good discrimination and calibration abilities. The concordance indexes in the primary and validation cohort were 0.66 and 0.65, respectively. ConclusionThis study reports the demographic, clinical and therapeutic predictors of relapse, and severe visual or motor disability in NMOSD. Early identification of patients at risk of unfavorable outcomes is of paramount importance to inform treatment decisions.
资助项目	National Natural Science Foundation of China [82171341, 81771296]; Shanghai Municipal Science and Technology Major Project [2018SHZDZX01]; ZHANGJIANG LAB; National Key Research and Development Program of China [2016YFC0901504]
出版者	FRONTIERS MEDIA SA
出版地	LAUSANNE
ISSN	1664-3224
卷号	13 页码:873576
DOI	10.3389/fimmu.2022.873576
页数	10
WOS类目	Immunology
WOS研究方向	Immunology
WOS记录号	WOS:000789111000001
收录类别	SCIE ; SCOPUS ; PUBMED
URL	查看原文
PubMed ID	35432315
SCOPUSEID	2-s2.0-85128382809
通讯作者地址	[Quan, Chao]Department of Neurology,Huashan Hospital,Shanghai Medical College,Fudan University,Shanghai,China
Scopus学科分类	Immunology and Allergy;Immunology
引用统计	被引频次：3[WOS] [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/148243
专题	第一临床医学院（信息与工程学院）、附属第一医院_内科学_神经内科
通讯作者	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 (NCND),Shanghai,China; 3.Department of Neurology,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,China; 4.Department of Rehabilitation Medicine,Jing’an District Centre Hospital of Shanghai,Fudan University,Shanghai,China; 5.Department of Rehabilitation Medicine,Huashan Hospital,Shanghai Medical College,Fudan University,Shanghai,China; 6.Department of Neurology,Jing’an District Centre Hospital of Shanghai,Fudan University,Shanghai,China; 7.Department of Neurology,The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou,China; 8.Department of Neurology,The First People’s Hospital of Yunnan Province,Kunming,China; 9.Department of Neurology,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou,China; 10.Department of Neurology,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou,China; 11.Department of Neurology,The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,China; 12.Department of Neurology,Wuhan No.1 Hospital,Wuhan,China; 13.Department of Neurology,Central Hospital,Shandong First Medical University,Jinan,China; 14.Department of Ophthalmology and Vision Science,Eye and ENT Hospital,Shanghai Medical College,Fudan University,Shanghai,China
推荐引用方式 GB/T 7714	Wang, Liang,Du, Lei,Li, Qinying,et al. Neuromyelitis Optica Spectrum Disorder With Anti-Aquaporin-4 Antibody: Outcome Prediction Models[J]. FRONTIERS IN IMMUNOLOGY,2022,13:873576.
APA	Wang, Liang., Du, Lei., Li, Qinying., Li, Fang., Wang, Bei., ... & Quan, Chao. (2022). Neuromyelitis Optica Spectrum Disorder With Anti-Aquaporin-4 Antibody: Outcome Prediction Models. FRONTIERS IN IMMUNOLOGY, 13, 873576.
MLA	Wang, Liang,et al."Neuromyelitis Optica Spectrum Disorder With Anti-Aquaporin-4 Antibody: Outcome Prediction Models".FRONTIERS IN IMMUNOLOGY 13(2022):873576.