title: Azathioprine plus corticosteroid treatment in Chinese patients with neuromyelitis optica.
abstract: We investigated the efficacy of azathioprine (AZA) plus long-term low dose corticosteroids in Chinese patients with neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorders (NMOSD) at the Center for Demyelinating Diseases, South China. We prospectively enrolled patients between June 2010 and June 2014. Annualized relapse rate (ARR), expanded disability status scale (EDSS) score and modified Rankin Scale (mRS) were analyzed retrospectively. Of 77 patients with NMO/NMOSD (four males, 73 females; age range: 4-69 years), median disease duration before initiation of AZA was 32.0 months (range: 2.0-197.0). Median post-treatment follow-up was 23 months (range: 6-58) and 44 patients (57.1%) were relapse-free at median follow-up 19 months (range: 6-51). Pre-treatment ARR was 0.923, and post-treatment ARR was 0 (p < 0.0001). Survival analysis indicated a significantly lower risk of relapse (hazard ratio 0.522; 95% confidence interval 0.377-0.722; p < 0.0001). Significant improvements were shown in the EDSS (3.0 versus 1.0; p < 0.0001) and mRS (2.0 versus 1.0; p < 0.0001). Our study provides evidence supporting the use of AZA plus a low dose corticosteroid as an effective and safe strategy which is associated with a reduction in the risk of relapse in Chinese patients with NMO.
authors.affiliation: Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong 510630, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Qiu
authors.affiliation: Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Department of Neurology, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Perth, WA, Australia; Institute of Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia.
authors.forename: Allan G
authors.initials: AG
authors.lastname: Kermode
authors.affiliation: Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong 510630, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong 510630, China.
authors.forename: Yongqiang
authors.initials: Y
authors.lastname: Dai
authors.affiliation: Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong 510630, China.
authors.forename: Yuge
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong 510630, China.
authors.forename: Jingqi
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong 510630, China.
authors.forename: Xiaonan
authors.initials: X
authors.lastname: Zhong
authors.affiliation: School of Mathematics and Computational Science, Sun Yat-sen University, Guangzhou, Guangdong, China.
authors.forename: Caixia
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong 510630, China.
authors.forename: Zhengqi
authors.initials: Z
authors.lastname: Lu
authors.affiliation: Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong 510630, China. Electronic address: huxueqiangzssy@qq.com.
authors.forename: Xueqiang
authors.initials: X
authors.lastname: Hu
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D044466:Asian People; D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002681:China; D004185:Disability Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000188:drug therapy*; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D001379:Azathioprine
keywords: Azathioprine; Corticosteroids; Neuromyelitis optica; Therapy