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Neuromyelitis optica (NMO or Devic’s syndrome) is a rare relapsing demyelinating disease of the central nervous system (CNS) that mainly affects the spinal cord and optic nerves and shares many clinical and radiological features with multiple sclerosis. The association of NMO with other autoimmune diseases was reported, but very few reports describ...
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Citations
... In the present study, the most frequent organ-specific autoimmune disease associated with NMOSD was autoimmune thyroid disease, which is usually not associated with CNS damage, consistent with other reports . Hashimoto thyroiditis, an antibody and cell-mediated autoimmune condition, was found to coexist with AQA4-Abpositive NMOSD [27,28]. Additionally, NMOSD has been associated with myasthenia gravis and most cases have MG prior to NMOSD onset, consistent with our results [9]. ...
Objectives
We aimed to determinate the frequency of this association and compare the features of neuromyelitis optica spectrum disorder (NMOSD) with and without associated autoimmune diseases (AD) in a Latin American (LATAM) population in clinical practice.Methods
We retrospectively reviewed the medical records of patients with NMOSD according to the 2015 diagnostic criteria. Patients from Argentina (n=77), Brazil (n=46), and Venezuela (n=17) were enrolled and classified into two groups as follows: with AD or without AD. Clinical, paraclinical (including aquaporin-4 antibodies (AQP4-ab) status), magnetic resonance imaging (MRI), and prognosis data were analyzed and compared. Kaplan-Meier (KM) and the Nelson-Aalen estimator analyses were performed to estimate both time and the cumulative hazard risk of disability reaching an EDSS≥4; and time for the first recurrence.ResultsOut of 140 patients, 33 (23.5%) patients had associated an AD at presentation. The most frequent associated AD was Hashimoto disease (n=10) followed by lupus (n=7) and Sjogren’s syndrome (n=6). However, rituximab use (42.4% vs. 21.5%, p=0.02), female gender (82.2% vs. 100%, p=0.006), corticospinal lesions on MRI (0% vs. 12.5%, p=0.01) at onset, and positivity for antinuclear antibodies (21.2% vs. 48.4%, p=0.03) were significantly associated with NMOSD patients with AD in comparison to NMOSD patients without AD. No differences were found in other clinical and paraclinical aspects between groups. KM and Nelson-Aalen estimator analyses did not show differences between groups.ConclusionNMOSD patients associated with AD were observed in 23.5%. In addition, NMOSD patients with and without associated AD were similar in most evaluated features.
Monoclonal-antibody has been used for patients with autoimmune disorders for several years, and efficacy and safety were appreciated for these patients. Neuromyelitis optica specturm disorders (NMOSD) has been defined as an autoimmune demyelination disorder of central nervous system (CNS) with a course of relapse-remission. Treatment of prevention is important for patients of NMOSD because of the increased disability after several attacks. Multiple factors were involved in the pathogenesis of NMOSD. Currently, targeting specific factor were favored in the research of treatment of NMOSD. Previous studies reported the efficacy and tolerance in NMOSD, such as rituximab, tocilizumab, eculizumab.
The aim of this article is to review the monoclonal therapies for NMOSD patients currently, also future alternatively options.
