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. 2018 Dec 6;4(4):2055217318815925.
doi: 10.1177/2055217318815925. eCollection 2018 Oct-Dec.

Updated diagnostic criteria for neuromyelitis optica spectrum disorder: Similar outcomes of previously separate cohorts

M McCreary  1 , M A Mealy  2 , D M Wingerchuk  3 , M Levy  2 , A DeSena  1 , B M Greenberg  1
Affiliations

Updated diagnostic criteria for neuromyelitis optica spectrum disorder: Similar outcomes of previously separate cohorts

M McCreary et al. Mult Scler J Exp Transl Clin. .

Abstract

Background: The specificity of the aquaporin-4 antibody to predict recurrent inflammatory central nervous system disease has led to the design of the 2015 neuromyelitis optica spectrum disorder criteria which capture all aquaporin-4 antibody seropositive patients.

Objective: The purpose of this study was to compare treatment outcomes in aquaporin-4 antibody seropositive patients who met the previous 2006 clinical criteria for neuromyelitis optica with patients who meet the 2015 neuromyelitis optica spectrum disorder criteria.

Methods: The study involved a three-center retrospective chart review of clinical outcomes among aquaporin-4 patients diagnosed with neuromyelitis optica and neuromyelitis optica spectrum disorder.

Results: Hazard ratios of relapse during immunosuppressive therapy, relative to pre-therapy, were not significantly different for patients who met the 2006 criteria of neuromyelitis optica versus the 2015 neuromyelitis optica spectrum disorder criteria among those treated with azathioprine ( p = 0.24), mycophenolate mofetil ( p = 0.63), or rituximab ( p = 0.97).

Conclusion: Reductions in the hazard of relapse during treatment with immunosuppressive therapies, relative to average pre-treatment, were not different for aquaporin-4 antibody seropositive patients categorized using the 2006 criteria of neuromyelitis optica and the 2015 neuromyelitis optica spectrum disorder criteria. These therapeutic findings support the design of the 2015 neuromyelitis optica spectrum disorder criteria which capture all aquaporin-4 antibody seropositive patients.

Keywords: Neuromyelitis optica; annual relapse rate; diagnostic criteria; neuromyelitis optica spectrum disorder; treatment response.

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Figures

Figure 1.
Figure 1.
Kaplan-Meier curves for time to first relapse after the initiation of (a) azathioprine, (b) cellcept, and (c) rituximab, stratified by final diagnosis of seropositive neuromyelitis optica (NMO) versus limited seropositive neuromyelitis optica spectrum disorder (NMOSD).
Figure 2.
Figure 2.
Relapse occurrence for patients receiving (a) azathioprine, (b) cellcept, and (c) rituximab as their initial neuromyelitis optica (NMO) preventative therapy, stratified by final diagnosis of seropositive NMO versus limited seropositive neuromyelitis optica spectrum disorder (NMOSD).
See this image and copyright information in PMC

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