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Immunotherapies in neuromyelitis optica spectrum disorder: efficacy and predictors of response

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Immunotherapies in neuromyelitis optica spectrum disorder: efficacy and predictors of response. / Stellmann, Jan-Patrick; Krumbholz, Markus; Friede, Tim; Gahlen, Anna; Borisow, Nadja; Fischer, Katrin; Hellwig, Kerstin; Pache, Florence; Ruprecht, Klemens; Havla, Joachim; Kümpfel, Tania; Aktas, Orhan; Hartung, Hans-Peter; Ringelstein, Marius; Geis, Christian; Kleinschnitz, Christoph; Berthele, Achim; Hemmer, Bernhard; Angstwurm, Klemens; Young, Kim Lea; Schuster, Simon; Stangel, Martin; Lauda, Florian; Tumani, Hayrettin; Mayer, Christoph; Zeltner, Lena; Ziemann, Ulf; Linker, Ralf Andreas; Schwab, Matthias; Marziniak, Martin; Then Bergh, Florian; Hofstadt-van Oy, Ulrich; Neuhaus, Oliver; Zettl, Uwe; Faiss, Jürgen; Wildemann, Brigitte; Paul, Friedemann; Jarius, Sven; Trebst, Corinna; Kleiter, Ingo; NEMOS (Neuromyelitis Optica Study Group).

In: J NEUROL NEUROSUR PS, Vol. 88, No. 8, 08.2017, p. 639-647.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Stellmann, J-P, Krumbholz, M, Friede, T, Gahlen, A, Borisow, N, Fischer, K, Hellwig, K, Pache, F, Ruprecht, K, Havla, J, Kümpfel, T, Aktas, O, Hartung, H-P, Ringelstein, M, Geis, C, Kleinschnitz, C, Berthele, A, Hemmer, B, Angstwurm, K, Young, KL, Schuster, S, Stangel, M, Lauda, F, Tumani, H, Mayer, C, Zeltner, L, Ziemann, U, Linker, RA, Schwab, M, Marziniak, M, Then Bergh, F, Hofstadt-van Oy, U, Neuhaus, O, Zettl, U, Faiss, J, Wildemann, B, Paul, F, Jarius, S, Trebst, C, Kleiter, I & NEMOS (Neuromyelitis Optica Study Group) 2017, 'Immunotherapies in neuromyelitis optica spectrum disorder: efficacy and predictors of response', J NEUROL NEUROSUR PS, vol. 88, no. 8, pp. 639-647. https://doi.org/10.1136/jnnp-2017-315603

APA

Stellmann, J-P., Krumbholz, M., Friede, T., Gahlen, A., Borisow, N., Fischer, K., Hellwig, K., Pache, F., Ruprecht, K., Havla, J., Kümpfel, T., Aktas, O., Hartung, H-P., Ringelstein, M., Geis, C., Kleinschnitz, C., Berthele, A., Hemmer, B., Angstwurm, K., ... NEMOS (Neuromyelitis Optica Study Group) (2017). Immunotherapies in neuromyelitis optica spectrum disorder: efficacy and predictors of response. J NEUROL NEUROSUR PS, 88(8), 639-647. https://doi.org/10.1136/jnnp-2017-315603

Vancouver

Stellmann J-P, Krumbholz M, Friede T, Gahlen A, Borisow N, Fischer K et al. Immunotherapies in neuromyelitis optica spectrum disorder: efficacy and predictors of response. J NEUROL NEUROSUR PS. 2017 Aug;88(8):639-647. https://doi.org/10.1136/jnnp-2017-315603

Bibtex

@article{cdd73dc646ef40339f384190a1cef0cf,
title = "Immunotherapies in neuromyelitis optica spectrum disorder: efficacy and predictors of response",
abstract = "OBJECTIVE: To analyse predictors for relapses and number of attacks under different immunotherapies in patients with neuromyelitis optica spectrum disorder (NMOSD).DESIGN: This is a retrospective cohort study conducted in neurology departments at 21 regional and university hospitals in Germany. Eligible participants were patients with aquaporin-4-antibody-positive or aquaporin-4-antibody-negative NMOSD. Main outcome measures were HRs from Cox proportional hazard regression models adjusted for centre effects, important prognostic factors and repeated treatment episodes.RESULTS: 265 treatment episodes with a mean duration of 442 days (total of 321 treatment years) in 144 patients (mean age at first attack: 40.9 years, 82.6% female, 86.1% aquaporin-4-antibody-positive) were analysed. 191 attacks occurred during any of the treatments (annual relapse rate=0.60). The most common treatments were rituximab (n=77, 111 patient-years), azathioprine (n=52, 68 patient-years), interferon-β (n=32, 61 patient-years), mitoxantrone (n=34, 32.1 patient-years) and glatiramer acetate (n=17, 10 patient-years). Azathioprine (HR=0.4, 95% CI 0.3 to 0.7, p=0.001) and rituximab (HR=0.6, 95% CI 0.4 to 1.0, p=0.034) reduced the attack risk compared with interferon-β, whereas mitoxantrone and glatiramer acetate did not. Patients who were aquaporin-4-antibody-positive had a higher risk of attacks (HR=2.5, 95% CI 1.3 to 5.1, p=0.009). Every decade of age was associated with a lower risk for attacks (HR=0.8, 95% CI 0.7 to 1.0, p=0.039). A previous attack under the same treatment tended to be predictive for further attacks (HR=1.5, 95% CI 1.0 to 2.4, p=0.065).CONCLUSIONS: Age, antibody status and possibly previous attacks predict further attacks in patients treated for NMOSD. Azathioprine and rituximab are superior to interferon-β.",
keywords = "Adult, Aquaporin 4, Autoantibodies, Azathioprine, Cohort Studies, Female, Follow-Up Studies, Germany, Glatiramer Acetate, Humans, Immunotherapy, Interferon-beta, Long-Term Care, Male, Middle Aged, Mitoxantrone, Neuromyelitis Optica, Prognosis, Recurrence, Registries, Retrospective Studies, Rituximab, Treatment Outcome, Comparative Study, Journal Article, Multicenter Study",
author = "Jan-Patrick Stellmann and Markus Krumbholz and Tim Friede and Anna Gahlen and Nadja Borisow and Katrin Fischer and Kerstin Hellwig and Florence Pache and Klemens Ruprecht and Joachim Havla and Tania K{\"u}mpfel and Orhan Aktas and Hans-Peter Hartung and Marius Ringelstein and Christian Geis and Christoph Kleinschnitz and Achim Berthele and Bernhard Hemmer and Klemens Angstwurm and Young, {Kim Lea} and Simon Schuster and Martin Stangel and Florian Lauda and Hayrettin Tumani and Christoph Mayer and Lena Zeltner and Ulf Ziemann and Linker, {Ralf Andreas} and Matthias Schwab and Martin Marziniak and {Then Bergh}, Florian and {Hofstadt-van Oy}, Ulrich and Oliver Neuhaus and Uwe Zettl and J{\"u}rgen Faiss and Brigitte Wildemann and Friedemann Paul and Sven Jarius and Corinna Trebst and Ingo Kleiter and {NEMOS (Neuromyelitis Optica Study Group)}",
note = "{\textcopyright} Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.",
year = "2017",
month = aug,
doi = "10.1136/jnnp-2017-315603",
language = "English",
volume = "88",
pages = "639--647",
journal = "J NEUROL NEUROSUR PS",
issn = "0022-3050",
publisher = "BMJ PUBLISHING GROUP",
number = "8",

}

RIS

TY - JOUR

T1 - Immunotherapies in neuromyelitis optica spectrum disorder: efficacy and predictors of response

AU - Stellmann, Jan-Patrick

AU - Krumbholz, Markus

AU - Friede, Tim

AU - Gahlen, Anna

AU - Borisow, Nadja

AU - Fischer, Katrin

AU - Hellwig, Kerstin

AU - Pache, Florence

AU - Ruprecht, Klemens

AU - Havla, Joachim

AU - Kümpfel, Tania

AU - Aktas, Orhan

AU - Hartung, Hans-Peter

AU - Ringelstein, Marius

AU - Geis, Christian

AU - Kleinschnitz, Christoph

AU - Berthele, Achim

AU - Hemmer, Bernhard

AU - Angstwurm, Klemens

AU - Young, Kim Lea

AU - Schuster, Simon

AU - Stangel, Martin

AU - Lauda, Florian

AU - Tumani, Hayrettin

AU - Mayer, Christoph

AU - Zeltner, Lena

AU - Ziemann, Ulf

AU - Linker, Ralf Andreas

AU - Schwab, Matthias

AU - Marziniak, Martin

AU - Then Bergh, Florian

AU - Hofstadt-van Oy, Ulrich

AU - Neuhaus, Oliver

AU - Zettl, Uwe

AU - Faiss, Jürgen

AU - Wildemann, Brigitte

AU - Paul, Friedemann

AU - Jarius, Sven

AU - Trebst, Corinna

AU - Kleiter, Ingo

AU - NEMOS (Neuromyelitis Optica Study Group)

N1 - © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PY - 2017/8

Y1 - 2017/8

N2 - OBJECTIVE: To analyse predictors for relapses and number of attacks under different immunotherapies in patients with neuromyelitis optica spectrum disorder (NMOSD).DESIGN: This is a retrospective cohort study conducted in neurology departments at 21 regional and university hospitals in Germany. Eligible participants were patients with aquaporin-4-antibody-positive or aquaporin-4-antibody-negative NMOSD. Main outcome measures were HRs from Cox proportional hazard regression models adjusted for centre effects, important prognostic factors and repeated treatment episodes.RESULTS: 265 treatment episodes with a mean duration of 442 days (total of 321 treatment years) in 144 patients (mean age at first attack: 40.9 years, 82.6% female, 86.1% aquaporin-4-antibody-positive) were analysed. 191 attacks occurred during any of the treatments (annual relapse rate=0.60). The most common treatments were rituximab (n=77, 111 patient-years), azathioprine (n=52, 68 patient-years), interferon-β (n=32, 61 patient-years), mitoxantrone (n=34, 32.1 patient-years) and glatiramer acetate (n=17, 10 patient-years). Azathioprine (HR=0.4, 95% CI 0.3 to 0.7, p=0.001) and rituximab (HR=0.6, 95% CI 0.4 to 1.0, p=0.034) reduced the attack risk compared with interferon-β, whereas mitoxantrone and glatiramer acetate did not. Patients who were aquaporin-4-antibody-positive had a higher risk of attacks (HR=2.5, 95% CI 1.3 to 5.1, p=0.009). Every decade of age was associated with a lower risk for attacks (HR=0.8, 95% CI 0.7 to 1.0, p=0.039). A previous attack under the same treatment tended to be predictive for further attacks (HR=1.5, 95% CI 1.0 to 2.4, p=0.065).CONCLUSIONS: Age, antibody status and possibly previous attacks predict further attacks in patients treated for NMOSD. Azathioprine and rituximab are superior to interferon-β.

AB - OBJECTIVE: To analyse predictors for relapses and number of attacks under different immunotherapies in patients with neuromyelitis optica spectrum disorder (NMOSD).DESIGN: This is a retrospective cohort study conducted in neurology departments at 21 regional and university hospitals in Germany. Eligible participants were patients with aquaporin-4-antibody-positive or aquaporin-4-antibody-negative NMOSD. Main outcome measures were HRs from Cox proportional hazard regression models adjusted for centre effects, important prognostic factors and repeated treatment episodes.RESULTS: 265 treatment episodes with a mean duration of 442 days (total of 321 treatment years) in 144 patients (mean age at first attack: 40.9 years, 82.6% female, 86.1% aquaporin-4-antibody-positive) were analysed. 191 attacks occurred during any of the treatments (annual relapse rate=0.60). The most common treatments were rituximab (n=77, 111 patient-years), azathioprine (n=52, 68 patient-years), interferon-β (n=32, 61 patient-years), mitoxantrone (n=34, 32.1 patient-years) and glatiramer acetate (n=17, 10 patient-years). Azathioprine (HR=0.4, 95% CI 0.3 to 0.7, p=0.001) and rituximab (HR=0.6, 95% CI 0.4 to 1.0, p=0.034) reduced the attack risk compared with interferon-β, whereas mitoxantrone and glatiramer acetate did not. Patients who were aquaporin-4-antibody-positive had a higher risk of attacks (HR=2.5, 95% CI 1.3 to 5.1, p=0.009). Every decade of age was associated with a lower risk for attacks (HR=0.8, 95% CI 0.7 to 1.0, p=0.039). A previous attack under the same treatment tended to be predictive for further attacks (HR=1.5, 95% CI 1.0 to 2.4, p=0.065).CONCLUSIONS: Age, antibody status and possibly previous attacks predict further attacks in patients treated for NMOSD. Azathioprine and rituximab are superior to interferon-β.

KW - Adult

KW - Aquaporin 4

KW - Autoantibodies

KW - Azathioprine

KW - Cohort Studies

KW - Female

KW - Follow-Up Studies

KW - Germany

KW - Glatiramer Acetate

KW - Humans

KW - Immunotherapy

KW - Interferon-beta

KW - Long-Term Care

KW - Male

KW - Middle Aged

KW - Mitoxantrone

KW - Neuromyelitis Optica

KW - Prognosis

KW - Recurrence

KW - Registries

KW - Retrospective Studies

KW - Rituximab

KW - Treatment Outcome

KW - Comparative Study

KW - Journal Article

KW - Multicenter Study

U2 - 10.1136/jnnp-2017-315603

DO - 10.1136/jnnp-2017-315603

M3 - SCORING: Journal article

C2 - 28572277

VL - 88

SP - 639

EP - 647

JO - J NEUROL NEUROSUR PS

JF - J NEUROL NEUROSUR PS

SN - 0022-3050

IS - 8

ER -