Effects of immunotherapies and prognostic predictors in neuromyelitis optica spectrum disorder: a prospective cohort study

摘要: Neuromyelitis optica spectrum disorder (NMOSD), a relapsing autoimmune demyelinating disease of the CNS, often leads to severe visual and/or motor disability. This study aimed evaluate long-term effects first-line immunotherapies on relapse and disability, identify prognostic predictors in NMOSD. In this prospective cohort study, we enrolled patients with NMOSD from Southwest China performed follow-up. We compared no (NIT) versus treatment mycophenolate mofetil (MMF), azathioprine (AZA), or only corticosteroid (CS). Cox proportional-hazards model was used explore Ultimately, 281 were during 2009 2017. The proportions relapse, mortality significantly lower treatments MMF AZA than NIT (all P < 0.001), while significant difference found between CS groups. multivariate analyses indicated that onset optic neuritis increased age at risk disability respectively. Comparing NIT, remarkably reduced but not Additionally, median time first longer (both P < 0.001). Furthermore, estimated for AQP4-Abs positive 1–5 years based identified above. Our revealed potential strengthened evidence early immunosuppressive treatments, such as AZA, could effectively reduce delayed progression