PLEX: the best first-line treatment in nmosd attacks experience at a single center in Colombia

Primary outcome was to evaluate complete improvement at six months after acute treatment in NMOSD relapses. Retrospective observational cohort study of patients with diagnosis of NMOSD admitted for acute attacks. We performed an explanatory analysis using the univariate, bivariate and multivariate l...

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Published inHeliyon Vol. 7; no. 4; p. e06811
Main Authors Restrepo-Aristizábal, C., Giraldo, L.M., Giraldo, Y.M., Pino-Pérez, A.M., Álvarez-Gómez, F., Franco, C.A., Tobón, J.V., Ascencio, J.L., Zuluaga, M.I.
Format Journal Article
LanguageEnglish
Published England Elsevier Ltd 01.04.2021
Elsevier
Subjects
All demyelinating disease (CNS)
Autoimmune diseases
Devic's syndrome
Optic neuritis
Transverse myelitis
All demyelinating disease (CNS)
Autoimmune diseases
Devic's syndrome
Optic neuritis
Transverse myelitis
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Abstract Primary outcome was to evaluate complete improvement at six months after acute treatment in NMOSD relapses. Retrospective observational cohort study of patients with diagnosis of NMOSD admitted for acute attacks. We performed an explanatory analysis using the univariate, bivariate and multivariate logistic regression approach. We compared survival curves using the Kaplan Meier analysis and estimated the median time for the main outcome. In the univariate analysis, basal EDSS score, AQP4-IgG positivity, PLEX as a first-line treatment (IVMP + PLEX), less systemic complications related to acute treatment and total attack history were independently associated with complete improvement at six months. After adjusting for confounding variables and using multivariate analysis by Cox Regression, positive AQ4-IgG (HR 0.04, 95% CI: 0.02–0.66) and IVMP + PLEX (HR 5.1, 95% CI: 3.9–66.4), were kept as independent factors associated to time to complete improvement. Time from admission to PLEX initiation and complete improvement at six months had a median of seven days (95% CI: 5.2–8.8). In secondary effects, there were no statistical differences between the groups. PLEX + IVMP is the treatment of choice for NMOSD relapses and should be initiated as early as possible. Devic's syndrome; Autoimmune diseases; Transverse myelitis; Optic neuritis; All Demyelinating disease (CNS).
AbstractList Primary outcome was to evaluate complete improvement at six months after acute treatment in NMOSD relapses. Retrospective observational cohort study of patients with diagnosis of NMOSD admitted for acute attacks. We performed an explanatory analysis using the univariate, bivariate and multivariate logistic regression approach. We compared survival curves using the Kaplan Meier analysis and estimated the median time for the main outcome. In the univariate analysis, basal EDSS score, AQP4-IgG positivity, PLEX as a first-line treatment (IVMP + PLEX), less systemic complications related to acute treatment and total attack history were independently associated with complete improvement at six months. After adjusting for confounding variables and using multivariate analysis by Cox Regression, positive AQ4-IgG (HR 0.04, 95% CI: 0.02-0.66) and IVMP + PLEX (HR 5.1, 95% CI: 3.9-66.4), were kept as independent factors associated to time to complete improvement. Time from admission to PLEX initiation and complete improvement at six months had a median of seven days (95% CI: 5.2-8.8). In secondary effects, there were no statistical differences between the groups. PLEX + IVMP is the treatment of choice for NMOSD relapses and should be initiated as early as possible.
OBJECTIVEPrimary outcome was to evaluate complete improvement at six months after acute treatment in NMOSD relapses. METHODSRetrospective observational cohort study of patients with diagnosis of NMOSD admitted for acute attacks. We performed an explanatory analysis using the univariate, bivariate and multivariate logistic regression approach. We compared survival curves using the Kaplan Meier analysis and estimated the median time for the main outcome. RESULTSIn the univariate analysis, basal EDSS score, AQP4-IgG positivity, PLEX as a first-line treatment (IVMP + PLEX), less systemic complications related to acute treatment and total attack history were independently associated with complete improvement at six months. After adjusting for confounding variables and using multivariate analysis by Cox Regression, positive AQ4-IgG (HR 0.04, 95% CI: 0.02-0.66) and IVMP + PLEX (HR 5.1, 95% CI: 3.9-66.4), were kept as independent factors associated to time to complete improvement. Time from admission to PLEX initiation and complete improvement at six months had a median of seven days (95% CI: 5.2-8.8). In secondary effects, there were no statistical differences between the groups. CONCLUSIONSPLEX + IVMP is the treatment of choice for NMOSD relapses and should be initiated as early as possible.
Primary outcome was to evaluate complete improvement at six months after acute treatment in NMOSD relapses. Retrospective observational cohort study of patients with diagnosis of NMOSD admitted for acute attacks. We performed an explanatory analysis using the univariate, bivariate and multivariate logistic regression approach. We compared survival curves using the Kaplan Meier analysis and estimated the median time for the main outcome. In the univariate analysis, basal EDSS score, AQP4-IgG positivity, PLEX as a first-line treatment (IVMP + PLEX), less systemic complications related to acute treatment and total attack history were independently associated with complete improvement at six months. After adjusting for confounding variables and using multivariate analysis by Cox Regression, positive AQ4-IgG (HR 0.04, 95% CI: 0.02–0.66) and IVMP + PLEX (HR 5.1, 95% CI: 3.9–66.4), were kept as independent factors associated to time to complete improvement. Time from admission to PLEX initiation and complete improvement at six months had a median of seven days (95% CI: 5.2–8.8). In secondary effects, there were no statistical differences between the groups. PLEX + IVMP is the treatment of choice for NMOSD relapses and should be initiated as early as possible. Devic's syndrome; Autoimmune diseases; Transverse myelitis; Optic neuritis; All Demyelinating disease (CNS).
Objective: Primary outcome was to evaluate complete improvement at six months after acute treatment in NMOSD relapses. Methods: Retrospective observational cohort study of patients with diagnosis of NMOSD admitted for acute attacks. We performed an explanatory analysis using the univariate, bivariate and multivariate logistic regression approach. We compared survival curves using the Kaplan Meier analysis and estimated the median time for the main outcome. Results: In the univariate analysis, basal EDSS score, AQP4-IgG positivity, PLEX as a first-line treatment (IVMP + PLEX), less systemic complications related to acute treatment and total attack history were independently associated with complete improvement at six months. After adjusting for confounding variables and using multivariate analysis by Cox Regression, positive AQ4-IgG (HR 0.04, 95% CI: 0.02–0.66) and IVMP + PLEX (HR 5.1, 95% CI: 3.9–66.4), were kept as independent factors associated to time to complete improvement. Time from admission to PLEX initiation and complete improvement at six months had a median of seven days (95% CI: 5.2–8.8). In secondary effects, there were no statistical differences between the groups. Conclusions: PLEX + IVMP is the treatment of choice for NMOSD relapses and should be initiated as early as possible.
Devic's syndrome; Autoimmune diseases; Transverse myelitis; Optic neuritis; All Demyelinating disease (CNS).
ArticleNumber e06811
Author Ascencio, J.L.
Pino-Pérez, A.M.
Franco, C.A.
Álvarez-Gómez, F.
Giraldo, Y.M.
Tobón, J.V.
Restrepo-Aristizábal, C.
Zuluaga, M.I.
Giraldo, L.M.
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Issue 4
Keywords All demyelinating disease (CNS)
Autoimmune diseases
Devic's syndrome
Optic neuritis
Transverse myelitis
Language English
License This is an open access article under the CC BY-NC-ND license.
2021 The Authors.
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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SSID ssj0001586973
Score 2.2530687
Snippet Primary outcome was to evaluate complete improvement at six months after acute treatment in NMOSD relapses. Retrospective observational cohort study of...
OBJECTIVEPrimary outcome was to evaluate complete improvement at six months after acute treatment in NMOSD relapses. METHODSRetrospective observational cohort...
Devic's syndrome; Autoimmune diseases; Transverse myelitis; Optic neuritis; All Demyelinating disease (CNS).
Objective: Primary outcome was to evaluate complete improvement at six months after acute treatment in NMOSD relapses. Methods: Retrospective observational...
SourceID doaj
pubmedcentral
proquest
crossref
pubmed
elsevier
SourceType Open Website
Open Access Repository
Aggregation Database
Index Database
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StartPage e06811
SubjectTerms All demyelinating disease (CNS)
Autoimmune diseases
Devic's syndrome
Optic neuritis
Transverse myelitis
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Title PLEX: the best first-line treatment in nmosd attacks experience at a single center in Colombia
URI https://dx.doi.org/10.1016/j.heliyon.2021.e06811
https://www.ncbi.nlm.nih.gov/pubmed/33948520
https://search.proquest.com/docview/2522392418
https://pubmed.ncbi.nlm.nih.gov/PMC8080073
https://doaj.org/article/d2b2befc108d4c65ba8b4ee4f28d5d6b
Volume 7
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