Assessing attacks and treatment response rates among adult patients with NMOSD and MOGAD: Data from a nationwide registry in Argentina

Contentti, Edgar Carnero; Lopez, Pablo A; Pettinicchi, Juan Pablo; Criniti, Juan; Pappolla, Agustín; Miguez, Jimena; Patrucco, Liliana; Carnero Contentti, Edgardo; Liwacki, Susana; Tkachuk, Verónica; Balbuena, María E; Vrech, Carlos; Deri, Norma; Correale, Jorge; Marrodan, Mariano; Ysrraelit, María C; Leguizamon, Felisa; Luetic, Geraldine; Menichini, María L; Tavolini, Darío; Mainella, Carolina; Zanga, Gisela; Burgos, Marcos; Hryb, Javier; Barboza, Andrés; Lazaro, Luciana; Alonso, Ricardo; Liguori, Nora Fernández; Nadur, Débora; Chercoff, Aníbal; Alonso Serena, Marina; Caride, Alejandro; Paul, Friedemann; Rojas, Juan I

We aimed to examine treatment interventions implemented in patients experiencing neuromyelitis optica spectrum disorders (NMOSD) attacks (frequency, types, and response). METHODS: Retrospective study. Data on patient demographic, clinical and radiological findings, and administered treatments were collected. Remission status (complete [CR], partial [PR], no remission [NR]), based on changes in the EDSS score was evaluated before treatment, during attack, and at 6 months. CR was analyzed with a generalized estimating equations (GEEs) model. RESULTS: A total of 131 patients (120 NMOSD and 11 myelin oligodendrocyte glycoprotein-antibody-associated diseases [MOGAD]), experiencing 262 NMOSD-related attacks and receiving 270 treatments were included. High-dose steroids (81.4%) was the most frequent treatment followed by plasmapheresis (15.5%). CR from attacks was observed in 47% (105/223) of all treated patients. During the first attack, we observed CR:71.2%, PR:16.3% and NR:12.5% after the first course of treatment. For second, third, fourth, and fifth attacks, CR was observed in 31.1%, 10.7%, 27.3%, and 33.3%, respectively. Remission rates were higher for optic neuritis vs. myelitis (p < 0.001). Predictor of CR in multivariate GEE analysis was age in both NMOSD (OR = 2.27, p = 0.002) and MOGAD (OR = 1.53, p = 0.03). CONCLUSIONS: This study suggests individualization of treatment according to age and attack manifestation. The outcome of attacks was generally poor.