ArticleJournal of neurology2025
Severe attacks and worse prognosis in patients with late-onset neuromyelitis optica spectrum disorder highlight the need for early highly effective treatment.
Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Exploring medication adherence and illness perception in patients with neuroimmune diseases: a cross-sectional study.Frontiers in immunology · 2026Article
- Systemic Lupus Erythematosus and Acute Transverse Myelitis: An Unusual Association-A Case Report.Case reports in medicine · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
BACKGROUND AND
objectivesPatients with late-onset neuromyelitis optica spectrum disorder (LO-NMOSD) have a worse prognosis than those with early onset NMOSD (EO-NMOSD), with limited immunotherapy data for patients with LO-NMOSD. We compared the efficacy of moderate and highly effective treatments for patients with LO-NMOSD.
methodsWe retrospectively included 695 aquaporin-4 immunoglobulin G-positive patients with EO-NMOSD (onset at age < 50 years) and LO-NMOSD (onset at age ≥ 50 years), comparing their clinical and immunologic features. Patients with LO-NMOSD were divided into two subgroups: one using moderately effective treatments, and one using highly effective treatments, focusing on relapse rates and prognostic outcomes.
resultsIn total, 208 (29.9%) patients had LO-NMOSD. The median disease duration was 4.21 years for the LO-NMOSD group and 7.33 years for the EO-NMOSD group. Patients with LO-NMOSD had a higher proportion of myelitis (47.6% vs. 31.2%) and higher Expanded Disability Status Scale (EDSS) scores at first attack [false discovery rate (FDR) corrected p = 0.001]. Severe attacks (EDSS ≥ 6) and motor disability at last follow-up was less common in EO-NMOSD. No difference in visual disability was observed between the two groups at last follow-up. Among patients with LO-NMOSD, 170 (81.7%) received moderately effective treatment and 38 (18.3%) received highly effective treatment. Patients using moderately effective treatments had a lower relapse-free rate than those using highly effective treatments (67.1% vs. 94.7%). DISCUSSION: Patients with LO-NMOSD had more severe attacks and worse prognoses than those with EO-NMOSD. Patients with LO-NMOSD may choose highly effective treatments as a first-line therapy.
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Registered trials
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