Evidence map›Paper›PMID 38790106›Full record

Observational studyCNS neuroscience & therapeutics2024

Efficacy and safety of apheresis therapy in AQP4 antibody-positive NMOSD attack: A propensity score-matched cohort study.

Yun Xu, Huabing Wang, Tian Song, Linlin Yin, Yajun Yao, Yuzhen Wei, Hengri Cong, Jiali Sun, Xinghu Zhang, De-Cai Tian

Abstract readObservational Study
In one paragraph

Observational study in CNS neuroscience & therapeutics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Review
  3. Article
  4. Article
  5. Observational
  6. Article
  7. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Yun XuCenter for Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.ORCID 0000-0002-2704-0892
Huabing WangCenter for Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Tian SongCenter for Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Linlin YinCenter for Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yajun YaoCenter for Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yuzhen WeiCenter for Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Hengri CongCenter for Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Jiali SunCenter for Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Xinghu ZhangCenter for Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
De-Cai TianCenter for Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.ORCID 0000-0002-5153-2491

Funding

Beijing Natural Science Foundation grant JQ23027National Natural Science Foundation of China 82271374
6 · The paper itself

Abstract

objectivePlasma exchange (PE) and immunoadsorption (IA) are recognized as effective ways to treat attacks in AQP4 antibody-positive NMOSD, but high-quality evidence was lacking. To evaluate the efficacy and safety of PE/IA plus intravenous methylprednisolone (IVMP) in NMOSD attacks using propensity scores to match IVMP as control.

methodsPatients were from a prospective observational cohort study. Stratification and interval propensity score matching (PSM) were used to reduce selection bias by matching baseline characteristics (gender, age, time to IVMP, EDSS at attack) between PE/IA + IVMP and IVMP group (in a ratio of 1:2). The primary endpoint of efficacy was EDSS change at 6 months. Adverse events and changes in laboratory tests were recorded.

resultsFour hundred and eleven attacks of 336 patients were screened for PSM, and 90 attacks (30 PE/IA + IVMP and 60 IVMP) were included in the analysis. There were significant differences in EDSS [6.25 vs. 6.75; IQR (4.50-8.38 vs. 5.00-8.00), p = 0.671] and visual acuity [median logMAR = 0.35 vs. 1.00; IQR (0.30-0.84 vs. 0.95-1.96), p = 0.002] change between two groups at 6 months. PE/IA + IVMP treatment demonstrated predictive capacity for good recovery as indicated by an area under the curve (AUC) of 0.726. Fibrinogen reduction was found during PE/IA + IVMP treatment [n = 15 (50.00%)], but no severe adverse events led to apheresis treatment discontinuation. DISCUSSION: After PSM analysis, IVMP+PE/IA in acute attack of NMOSD achieved better and continuous improvement in neurological function within 6 months compared with IVMP alone. PE/IA treatment showed a good safety profile.

Indexed as

Aquaporin 4Blood Component RemovalNeuromyelitis OpticaPropensity ScoreAdultAutoantibodiesCohort StudiesFemaleHumansMaleMethylprednisoloneMiddle AgedPlasma ExchangeProspective StudiesTreatment OutcomeAQP4 protein, humanAquaporin 4AutoantibodiesMethylprednisoloneacute attackimmunoadsorptionNMOSDplasma exchangePSM

Identifiers

PMID38790106
PMCPMC11126786

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.