Effects of early using azathioprine in the acute phase in neuromyelitis optica spectrum disorder. (3rd June 2017)

• Record Type: Journal Article
• Authors: Lin, Jie; Xue, Binbin; Chen, Zhibo; Huang, Xiaming; Pang, Wanhui; Quan, Weiwei; Huang, Yuanyuan; Li, Xiang; Xia, Junhui
• Is Part Of: International journal of neuroscience. Volume 127:Number 6(2017)
• Page Start: 508
• Page End: 515
• Publication Date: 2017-06-03
• Subjects: neuromyelitis optica spectrum disorder -- azathioprine -- glucocorticoids; Nervous system -- Periodicals; 612.805
• DOI: 10.1080/00207454.2016.1201665
• Languages: English
• ISSNs: 0020-7454

Abstract

Abstract : Background : Azathioprine is widely used for neuromyelitis optica spectrum disorder (NMOSD) patients, while a consensus of timing to receive azathioprine has not been proposed. Objective : The objective of this paper was to evaluate the efficacy of early access of azathioprine in NMOSD patients. Methods : We conducted a retrospective review of NMOSD patients based on medical records. Included patients were divided into three groups: group IVMT + AZA, group AZA after IVMT and group IVMT. Time to next relapse was adopted as the endpoint. Results : Patients from group IVMT + AZA had a longer duration of remission compared with patients from group AZA after IVMT ( p = 0.025) and group IVMT ( p < 0.001), and longer duration showed in the group AZA after IVMT when compared with group IVMT ( p = 0.005). We found that older age of initial attack was a risk factor for NMOSD patients (HR: 1.235; p = 0.022), and younger age of receiving treatment was a protect factor (HR: 0.804; p = 0.023). Partial patients have used azathioprine before this study in group IVMT + AZA, result showed there was no significance between the patients who had or had not used azathioprine ( p = 0.299). Conclusion : Azathioprine could prolong the duration of remission after treatment, especially given within two weeks after attack. Patients who received azathioprine combined with glucocorticoids had a preferable effect than glucocorticoids alone in the remission.