Aquaporin-4 serostatus does not predict response to immunotherapy in neuromyelitis optica spectrum disorders

Maureen A. Mealy, Su Hyun Kim, Felix Schmidt, Reydmar López, Jorge A. Jimenez Arango, Friedemann Paul, Dean M. Wingerchuk, Benjamin M. Greenberg, Ho Jin Kim, Michael Levy

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Debate exists about whether neuromyelitis optica spectrum disorder seronegative disease represents the same immune-mediated attack on astrocytic aquaporin-4 as in seropositive disease. Objective: We investigated whether response to common treatments for neuromyelitis optica spectrum disorder differed by serostatus, as assessed by change in annualized relapse rate. Methods: We performed a multicenter retrospective analysis of 245 patients with neuromyelitis optica spectrum disorder who were treated with either rituximab or mycophenolate mofetil as their first-line immunosuppressive treatment for disease prevention. Patients were followed for a minimum of 6 months following treatment initiation. Results: In those started on rituximab, the pre-treatment annualized relapse rates for seropositive and seronegative patients were 1.81 and 1.93, respectively. On-treatment annualized relapse rates significantly declined to 0.32 (seropositive; p < 0.0001) and 0.12 (seronegative; p = 0.0001). In those started on mycophenolate mofetil, the pre-treatment annualized relapse rates for seropositive and seronegative patients were 1.79 and 1.45, respectively. On-treatment annualized relapse rates declined to 0.29 (seropositive; p < 0.0001) and 0.30 (seronegative; p < 0.005). Conclusion: In this international collaboration involving a large number of neuromyelitis optica spectrum disorder patients, treatment was effective regardless of serostatus. This suggests that treatment should not differ when considering these treatments.

Original languageEnglish (US)
JournalMultiple Sclerosis Journal
DOIs
StateAccepted/In press - Aug 1 2017

Fingerprint

Aquaporin 4
Neuromyelitis Optica
Immunotherapy
Recurrence
Mycophenolic Acid
Therapeutics
Immunosuppressive Agents

Keywords

  • Devic’s disease
  • immunosuppression
  • mycophenolate
  • neuromyelitis optica
  • relapse
  • rituximab

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Mealy, M. A., Kim, S. H., Schmidt, F., López, R., Jimenez Arango, J. A., Paul, F., ... Levy, M. (Accepted/In press). Aquaporin-4 serostatus does not predict response to immunotherapy in neuromyelitis optica spectrum disorders. Multiple Sclerosis Journal. https://doi.org/10.1177/1352458517730131

Aquaporin-4 serostatus does not predict response to immunotherapy in neuromyelitis optica spectrum disorders. / Mealy, Maureen A.; Kim, Su Hyun; Schmidt, Felix; López, Reydmar; Jimenez Arango, Jorge A.; Paul, Friedemann; Wingerchuk, Dean M.; Greenberg, Benjamin M.; Kim, Ho Jin; Levy, Michael.

In: Multiple Sclerosis Journal, 01.08.2017.

Research output: Contribution to journalArticle

Mealy, Maureen A. ; Kim, Su Hyun ; Schmidt, Felix ; López, Reydmar ; Jimenez Arango, Jorge A. ; Paul, Friedemann ; Wingerchuk, Dean M. ; Greenberg, Benjamin M. ; Kim, Ho Jin ; Levy, Michael. / Aquaporin-4 serostatus does not predict response to immunotherapy in neuromyelitis optica spectrum disorders. In: Multiple Sclerosis Journal. 2017.
@article{a335fb06b6904e7b9e9d93d258dbb150,
title = "Aquaporin-4 serostatus does not predict response to immunotherapy in neuromyelitis optica spectrum disorders",
abstract = "Background: Debate exists about whether neuromyelitis optica spectrum disorder seronegative disease represents the same immune-mediated attack on astrocytic aquaporin-4 as in seropositive disease. Objective: We investigated whether response to common treatments for neuromyelitis optica spectrum disorder differed by serostatus, as assessed by change in annualized relapse rate. Methods: We performed a multicenter retrospective analysis of 245 patients with neuromyelitis optica spectrum disorder who were treated with either rituximab or mycophenolate mofetil as their first-line immunosuppressive treatment for disease prevention. Patients were followed for a minimum of 6 months following treatment initiation. Results: In those started on rituximab, the pre-treatment annualized relapse rates for seropositive and seronegative patients were 1.81 and 1.93, respectively. On-treatment annualized relapse rates significantly declined to 0.32 (seropositive; p < 0.0001) and 0.12 (seronegative; p = 0.0001). In those started on mycophenolate mofetil, the pre-treatment annualized relapse rates for seropositive and seronegative patients were 1.79 and 1.45, respectively. On-treatment annualized relapse rates declined to 0.29 (seropositive; p < 0.0001) and 0.30 (seronegative; p < 0.005). Conclusion: In this international collaboration involving a large number of neuromyelitis optica spectrum disorder patients, treatment was effective regardless of serostatus. This suggests that treatment should not differ when considering these treatments.",
keywords = "Devic’s disease, immunosuppression, mycophenolate, neuromyelitis optica, relapse, rituximab",
author = "Mealy, {Maureen A.} and Kim, {Su Hyun} and Felix Schmidt and Reydmar L{\'o}pez and {Jimenez Arango}, {Jorge A.} and Friedemann Paul and Wingerchuk, {Dean M.} and Greenberg, {Benjamin M.} and Kim, {Ho Jin} and Michael Levy",
year = "2017",
month = "8",
day = "1",
doi = "10.1177/1352458517730131",
language = "English (US)",
journal = "Multiple Sclerosis",
issn = "1352-4585",
publisher = "SAGE Publications Ltd",

}

TY - JOUR

T1 - Aquaporin-4 serostatus does not predict response to immunotherapy in neuromyelitis optica spectrum disorders

AU - Mealy, Maureen A.

AU - Kim, Su Hyun

AU - Schmidt, Felix

AU - López, Reydmar

AU - Jimenez Arango, Jorge A.

AU - Paul, Friedemann

AU - Wingerchuk, Dean M.

AU - Greenberg, Benjamin M.

AU - Kim, Ho Jin

AU - Levy, Michael

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Background: Debate exists about whether neuromyelitis optica spectrum disorder seronegative disease represents the same immune-mediated attack on astrocytic aquaporin-4 as in seropositive disease. Objective: We investigated whether response to common treatments for neuromyelitis optica spectrum disorder differed by serostatus, as assessed by change in annualized relapse rate. Methods: We performed a multicenter retrospective analysis of 245 patients with neuromyelitis optica spectrum disorder who were treated with either rituximab or mycophenolate mofetil as their first-line immunosuppressive treatment for disease prevention. Patients were followed for a minimum of 6 months following treatment initiation. Results: In those started on rituximab, the pre-treatment annualized relapse rates for seropositive and seronegative patients were 1.81 and 1.93, respectively. On-treatment annualized relapse rates significantly declined to 0.32 (seropositive; p < 0.0001) and 0.12 (seronegative; p = 0.0001). In those started on mycophenolate mofetil, the pre-treatment annualized relapse rates for seropositive and seronegative patients were 1.79 and 1.45, respectively. On-treatment annualized relapse rates declined to 0.29 (seropositive; p < 0.0001) and 0.30 (seronegative; p < 0.005). Conclusion: In this international collaboration involving a large number of neuromyelitis optica spectrum disorder patients, treatment was effective regardless of serostatus. This suggests that treatment should not differ when considering these treatments.

AB - Background: Debate exists about whether neuromyelitis optica spectrum disorder seronegative disease represents the same immune-mediated attack on astrocytic aquaporin-4 as in seropositive disease. Objective: We investigated whether response to common treatments for neuromyelitis optica spectrum disorder differed by serostatus, as assessed by change in annualized relapse rate. Methods: We performed a multicenter retrospective analysis of 245 patients with neuromyelitis optica spectrum disorder who were treated with either rituximab or mycophenolate mofetil as their first-line immunosuppressive treatment for disease prevention. Patients were followed for a minimum of 6 months following treatment initiation. Results: In those started on rituximab, the pre-treatment annualized relapse rates for seropositive and seronegative patients were 1.81 and 1.93, respectively. On-treatment annualized relapse rates significantly declined to 0.32 (seropositive; p < 0.0001) and 0.12 (seronegative; p = 0.0001). In those started on mycophenolate mofetil, the pre-treatment annualized relapse rates for seropositive and seronegative patients were 1.79 and 1.45, respectively. On-treatment annualized relapse rates declined to 0.29 (seropositive; p < 0.0001) and 0.30 (seronegative; p < 0.005). Conclusion: In this international collaboration involving a large number of neuromyelitis optica spectrum disorder patients, treatment was effective regardless of serostatus. This suggests that treatment should not differ when considering these treatments.

KW - Devic’s disease

KW - immunosuppression

KW - mycophenolate

KW - neuromyelitis optica

KW - relapse

KW - rituximab

UR - http://www.scopus.com/inward/record.url?scp=85040905085&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040905085&partnerID=8YFLogxK

U2 - 10.1177/1352458517730131

DO - 10.1177/1352458517730131

M3 - Article

JO - Multiple Sclerosis

JF - Multiple Sclerosis

SN - 1352-4585

ER -