Comparative analysis of immunosuppressive therapies for myelin oligodendrocyte glycoprotein antibody-associated optic neuritis: a cohort study
Autor: | Lindan Xie, Ying Meng Lai, Honglu Song, Quangang Xu, Huanfen Zhou, Mo Yang, Shihui Wei, Mingming Sun |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Optic Neuritis Gastroenterology Myelin oligodendrocyte glycoprotein Cohort Studies Cellular and Molecular Neuroscience Recurrence Internal medicine medicine Humans Optic neuritis Autoantibodies Immunosuppression Therapy biology business.industry Mycophenolic Acid medicine.disease Sensory Systems Discontinuation Ophthalmology Tolerability Optic nerve biology.protein Myelin-Oligodendrocyte Glycoprotein Rituximab Antibody business Immunosuppressive Agents Cohort study medicine.drug |
Zdroj: | British Journal of Ophthalmology. 106:1587-1595 |
ISSN: | 1468-2079 0007-1161 |
Popis: | AimsThe optimal immunosuppressive therapy (IST) in patients with myelin oligodendrocyte glycoprotein antibody-associated optic neuritis (MOG-ON) remains uncertain. This study aimed to observe the disease course of MOG-ON and evaluate the therapeutic efficacy and tolerability of conventional immunosuppressants through Chinese cohort analysis.MethodsThis bidirectional cohort study included 121 patients with MOG-ON between January 2015 and December 2018. The clinical features and annualised relapse rate (ARR) of patients with and without IST were analysed.ResultsThe median age at onset was 17.5 years, and the sex ratio (F:M) was 1.24. Of 121 patients, 77 patients relapsed and 61 patients were younger than 18 years at disease onset. The overall median ARR of 63 patients in the non-IST group was 0.5, with 46.0% patients showing relapse at a median follow-up of 33.5 months. In the IST group, the ARR decreased from 1.75 pre-IST to 0.00 post-IST in 53 patients who received IST exceeding 6 months, with 20.8% patients showing relapse at a median follow-up of 23.8 months. The relapse rates of patients treated with rituximab (RTX) and mycophenolate mofetil (MMF) were not statistically different, but the rate of discontinuation was significantly lower in the RTX-treated group (18.2% vs 57.7%, p=0.0017).ConclusionThis study provides Class III evidence that both MMF and RTX may lower disease activity in patients with MOG-ON, and RTX showed better tolerability than MMF. However, observation after a single attack remains a good option because less than half of patients not on treatment suffered a relapse. |
Databáze: | OpenAIRE |
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