在发生MOGAD患者中复发和残疾的结果,在发病后接受警等待的MOGAD患者
Nanthaya Tisavipat1, Adi Wilf-Yarkoni2, Abdullah Al-Ani3
1Department of Neurology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA; Center for MS and Autoimmune Neurology, Mayo Clinic, USA.
Multiple sclerosis and related disorders
|July 25, 2025
概括
在初次患有髓寡细胞蛋白抗体相关疾病 (MOGAD) 发作后,保持警等待对一些患者来说是一个可行的选择. 虽然63%的人经历了复发,但不利的残疾结果并不常见,剩下的三分之一是单相.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 神经免疫学 神经免疫学
背景情况:
- 髓寡腺细胞糖蛋白抗体相关疾病 (MOGAD) 的管理通常涉及在最初的攻击后的观察,因为不确定的复发风险.
- 在MOGAD患者中观察性等待方法的结果在很大程度上仍未被探索.
研究的目的:
- 为了评估MOGAD患者中复发和不良残疾进展的风险,在他们的第一次临床发作后进行了警等待.
- 在事件MOGAD案件中评估保守管理的长期结果.
主要方法:
- 一个国际的,多中心的,追溯的病例系列包括81例MOGAD患者,符合2023年的诊断标准,至少有3年的随访.
- 从加拿大,以色列,泰国和美国的四个高等保健中心收集了数据.
- 仅分析了事件事件,以减轻转诊偏差.
主要成果:
- 80% (65/81) 的患者在最初的MOGAD攻击后进行了警等待.
- 有一个显著的比例,63% (41/65),经历了复发,年复发率的中位数为0.27.
- 不利的残疾结果 (EDSS ≥2.0) 发生在19% (12/64) 的警等待患者中,大多数归因于最初的攻击而不是复发.
结论:
- 对一小部分MOGAD患者来说,警等待可能是一个合适的策略,因为三分之一的患者仍然是单相.
- 由于复发导致的不良残疾结果的低发病率支持继续观察作为潜在的管理选择.
- 需要进一步的研究来确定复发的预测因素,并指导MOGAD中的个性化治疗决策.
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