Neuromyelitis optica treatment: analysis of 36 patients.
OBJECTIVE
To analyze treatment response in Brazilian patients with neuromyelitis optica.


METHODS
Retrospective review.


METHODS
Neuroimmunology Clinic of the Federal University of São Paulo, São Paulo, Brazil. Patients  Thirty-six patients with relapsing-remitting optic-spinal disease; long, extending spinal cord lesions; and brain magnetic resonance images not meeting Barkhof criteria for multiple sclerosis, thus fulfilling the 1999 and 2006 criteria for neuromyelitis optica. Patients were followed up from 1994 to 2007.


METHODS
Relapses and accumulation of disability.


RESULTS
Mean follow-up time was 47.2 months and mean age at onset was 32.3 years. Sixty-four treatments were implemented in 36 patients, which included interferon beta, methotrexate, cyclophosphamide, prednisone, and azathioprine solely or plus prednisone. Patients who were treated with azathioprine or azathioprine with prednisone had a reduction in the occurrence of relapses and Expanded Disability Severity Scale score stabilization, as opposed to patients who received other treatments. Of the 4 patients who died, only 1 had received azathioprine treatment.


CONCLUSIONS
Azathioprine as monotherapy or with prednisone seems to have reduced the relapse frequency and halted disability progression in the majority of patients treated, with minor and manageable adverse effects.
Bichuetti
Denis Bernardi
DB
Departamento de Neurologia, Universidade Federal de São Paulo, Rua Botucatu, São Paulo, Brazil. denisbichuetti@globo.com
Lobato de Oliveira
Enedina Maria
EM
Oliveira
Daniel May
DM
Amorin de Souza
Nilton
N
Gabbai
Alberto Alain
AA
D000328:Adult; D017668:Age of Onset; D001938:Brazil; D018450:Disease Progression; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
D007166:Immunosuppressive Agents