title: Neuromyelitis optica treatment: analysis of 36 patients.
abstract: 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.
authors.affiliation: Departamento de Neurologia, Universidade Federal de São Paulo, Rua Botucatu, São Paulo, Brazil. denisbichuetti@globo.com
authors.forename: Denis Bernardi
authors.initials: DB
authors.lastname: Bichuetti
authors.forename: Enedina Maria
authors.initials: EM
authors.lastname: Lobato de Oliveira
authors.forename: Daniel May
authors.initials: DM
authors.lastname: Oliveira
authors.forename: Nilton
authors.initials: N
authors.lastname: Amorin de Souza
authors.forename: Alberto Alain
authors.initials: AA
authors.lastname: Gabbai
mesh_terms: 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
chemical_list: D007166:Immunosuppressive Agents