title: Efficacy of glatiramer acetate in neuromyelitis optica spectrum disorder: a multicenter retrospective study.
abstract: Glatiramer acetate (GA) is an approved therapy for relapsing-remitting multiple sclerosis, but its efficacy for the prevention of attacks in neuromyelitis optica spectrum disorder (NMOSD) remains unknown. We did a multicenter retrospective analysis of GA-treated patients with NMOSD, identified through a national registry. Annualized relapse rate and expanded disability status scale (EDSS) were the main outcome measures. We identified 23 GA-treated patients (21 female, 16 aquaporin-4 antibody-positive). GA was given for <6 months in seven patients; reasons for stopping were relapses (n = 3), confirmation of NMOSD (n = 2) and side effects (n = 2). Of 16 patients treated ≥ 6 months with GA (15 female, 11 aquaporin-4 antibody-positive), 14 experienced at least one relapse. There was no reduction in the mean annualized relapse rate in the total group (1.9 ± 1.1 before vs. 1.8 ± 1.4 during GA therapy), as well as in those patients who were aquaporin-4 antibody-positive, or had a history of prior immunotherapy or not. The median EDSS increased (2.5 start vs. 3.5 finish of GA, P < 0.05). GA therapy was discontinued in 15/16 patients; reasons were therapeutic inefficacy in 13 and post-injection skin reactions in two patients. We conclude that GA is not beneficial for preventing attacks in most patients with NMOSD, particularly in aquaporin-4 antibody-positive cases.
authors.affiliation: Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Gudrunstr. 56, 44791, Bochum, Germany.
authors.forename: Ilya
authors.initials: I
authors.lastname: Ayzenberg
authors.affiliation: Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Gudrunstr. 56, 44791, Bochum, Germany.
authors.forename: Joanna
authors.initials: J
authors.lastname: Schöllhammer
authors.affiliation: Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Gudrunstr. 56, 44791, Bochum, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Hoepner
authors.affiliation: Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Gudrunstr. 56, 44791, Bochum, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Hellwig
authors.affiliation: Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
authors.forename: Marius
authors.initials: M
authors.lastname: Ringelstein
authors.affiliation: Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
authors.forename: Orhan
authors.initials: O
authors.lastname: Aktas
authors.affiliation: Institute of Clinical Neuroimmunology, Faculty of Medicine, Ludwig Maximilians University, Munich, Germany.
authors.forename: Tania
authors.initials: T
authors.lastname: Kümpfel
authors.affiliation: Institute of Clinical Neuroimmunology, Faculty of Medicine, Ludwig Maximilians University, Munich, Germany.|Department of Neurology and Stroke, and Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Krumbholz
authors.affiliation: Department of Neurology, Hannover Medical School, Hannover, Germany.
authors.forename: Corinna
authors.initials: C
authors.lastname: Trebst
authors.affiliation: Neurocure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.|Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Friedemann
authors.initials: F
authors.lastname: Paul
authors.affiliation: Neurocure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center, Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Florence
authors.initials: F
authors.lastname: Pache
authors.affiliation: Department of Neurology, University of Essen, Essen, Germany.
authors.forename: Mark
authors.initials: M
authors.lastname: Obermann
authors.affiliation: Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany.
authors.forename: Lena
authors.initials: L
authors.lastname: Zeltner
authors.affiliation: Department of Neurology, Jena University Hospital, Jena, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Schwab
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Achim
authors.initials: A
authors.lastname: Berthele
authors.affiliation: Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Jarius
authors.affiliation: Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Gudrunstr. 56, 44791, Bochum, Germany. ingo.kleiter@rub.de.
authors.forename: Ingo
authors.initials: I
authors.lastname: Kleiter
mesh_terms: D000328:Adult; D000906:Antibodies / Q000097:blood; D051401:Aquaporin 4 / Q000276:immunology; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D000068717:Glatiramer Acetate / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000188:drug therapy*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C496030:AQP4 protein, human; D000906:Antibodies; D051401:Aquaporin 4; D007166:Immunosuppressive Agents; D000068717:Glatiramer Acetate
keywords: Aquaporin-4 antibody; Devic’s disease; Glatiramer acetate; Myelitis; Neuromyelitis optica spectrum disorder; Optic neuritis
references.citation: Ann N Y Acad Sci. 2013 Apr;1283:57-66
references.pmid: 23617588
references.citation: Ann Neurol. 2001 Mar;49(3):290-7
references.pmid: 11261502
references.citation: Neurology. 2015 Jul 14;85(2):177-89
references.pmid: 26092914
references.citation: Brain Pathol. 2013 Nov;23(6):661-83
references.pmid: 24118483
references.citation: JAMA Neurol. 2014 Nov;71(11):1372-8
references.pmid: 25199960
references.citation: Neurotherapeutics. 2016 Jan;13(1):70-83
references.pmid: 26597098
references.citation: J Neuroimmunol. 2010 Feb 26;219(1-2):47-53
references.pmid: 20034680
references.citation: JAMA Neurol. 2014 Mar;71(3):324-30
references.pmid: 24445513
references.citation: Ann Neurol. 2012 Jul;72(1):53-64
references.pmid: 22807325
references.citation: J Neuroinflammation. 2012 Jan 19;9:14
references.pmid: 22260418
references.citation: Ann Neurol. 2009 Nov;66(5):630-43
references.pmid: 19937948
references.citation: J Neurol Neurosurg Psychiatry. 2013 May;84(5):511-6
references.pmid: 23138769
references.citation: Clin Exp Immunol. 2014 May;176(2):149-64
references.pmid: 24666204
references.citation: Brain. 2003 Jun;126(Pt 6):1E; author reply 1E-a
references.pmid: 12764069
references.citation: J Neuroimmunol. 2008 Nov 15;204(1-2):58-65
references.pmid: 18804287
references.citation: JAMA Neurol. 2015 Jul;72 (7):756-63
references.pmid: 25985228
references.citation: Neurol Neuroimmunol Neuroinflamm. 2015 Jan 22;2(1):e62
references.pmid: 25635259
references.citation: Eur J Neurol. 2007 Jun;14(6):e12-3
references.pmid: 17539924
references.citation: Brain. 2008 Nov;131(Pt 11):3072-80
references.pmid: 18945724
references.citation: Neurology. 2014 Apr 15;82(15):1302-6
references.pmid: 24634453
references.citation: JAMA Neurol. 2013 Sep 1;70(9):1110-7
references.pmid: 23897062
references.citation: J Neurol. 2014 Jan;261(1):1-16
references.pmid: 24272588
references.citation: Neurology. 2010 Oct 19;75(16):1423-7
references.pmid: 20826711
references.citation: BMC Neurol. 2014 Jan 29;14:21
references.pmid: 24475777
references.citation: JAMA Neurol. 2014 Nov;71(11):1421-8
references.pmid: 25264704
references.citation: Arch Neurol. 2010 Aug;67(8):1016-7
references.pmid: 20697055
references.citation: Neurology. 1995 Jul;45(7):1268-76
references.pmid: 7617181
references.citation: Lancet. 2004 Dec 11-17;364(9451):2106-12
references.pmid: 15589308
references.citation: Med Hypotheses. 2011 Jun;76(6):820-2
references.pmid: 21398045
references.citation: J Clin Apher. 2012;27(4):183-92
references.pmid: 22488449
references.citation: Arch Neurol. 2012 Feb;69(2):239-45
references.pmid: 22332191
references.citation: J Neurol. 2009 Dec;256(12):2082-4
references.pmid: 19655191
references.citation: Eur J Neurol. 2010 Aug;17(8):1019-32
references.pmid: 20528913
references.citation: J Neurol Neurosurg Psychiatry. 2013 Aug;84(8):918-21
references.pmid: 23467418