Effects of early using azathioprine in the acute phase in neuromyelitis optica spectrum disorder.
BACKGROUND
Azathioprine is widely used for neuromyelitis optica spectrum disorder (NMOSD) patients, while a consensus of timing to receive azathioprine has not been proposed.


OBJECTIVE
The objective of this paper was to evaluate the efficacy of early access of azathioprine in NMOSD patients.


METHODS
We conducted a retrospective review of NMOSD patients based on medical records. Included patients were divided into three groups: group IVMT + AZA, group AZA after IVMT and group IVMT. Time to next relapse was adopted as the endpoint.


RESULTS
Patients from group IVMT + AZA had a longer duration of remission compared with patients from group AZA after IVMT ( p = 0.025) and group IVMT ( p < 0.001), and longer duration showed in the group AZA after IVMT when compared with group IVMT ( p = 0.005). We found that older age of initial attack was a risk factor for NMOSD patients (HR: 1.235; p = 0.022), and younger age of receiving treatment was a protect factor (HR: 0.804; p = 0.023). Partial patients have used azathioprine before this study in group IVMT + AZA, result showed there was no significance between the patients who had or had not used azathioprine ( p = 0.299).


CONCLUSIONS
Azathioprine could prolong the duration of remission after treatment, especially given within two weeks after attack. Patients who received azathioprine combined with glucocorticoids had a preferable effect than glucocorticoids alone in the remission.
a Department of Neurology , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China.
Jie
J
Lin
b Department of Anesthesiology , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China.
Binbin
B
Xue
a Department of Neurology , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China.
Zhibo
Z
Chen
c Department of Hepatobiliary Surgery , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China.
Xiaming
X
Huang
a Department of Neurology , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China.
Wanhui
W
Pang
a Department of Neurology , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China.
Weiwei
W
Quan
a Department of Neurology , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China.
Yuanyuan
Y
Huang
a Department of Neurology , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China.
Xiang
X
Li
a Department of Neurology , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China.
Junhui
J
Xia
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001379:Azathioprine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007275:Injections, Intravenous; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000188:drug therapy*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D055815:Young Adult
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D001379:Azathioprine; D008775:Methylprednisolone
azathioprine; glucocorticoids; neuromyelitis optica spectrum disorder