Efficacy and safety of tacrolimus treatment for neuromyelitis optica spectrum disorder

Abstract Neuromyelitis optica spectrum disorder (NMOSD) is a severe inflammatory autoimmune disease that mainly involves the optic nerves and spinal cord, causing blindness and paralysis. Although some immunosuppressants such as rituximab and azathioprine have proven to be effective in relapse preve...

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Autores principales:	Bo Chen, Qian Wu, Gaotan Ke, Bitao Bu
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1f137cfed6b04df994fecc21c524491f
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spelling	oai:doaj.org-article:1f137cfed6b04df994fecc21c524491f2021-12-02T12:32:31ZEfficacy and safety of tacrolimus treatment for neuromyelitis optica spectrum disorder10.1038/s41598-017-00860-y2045-2322https://doaj.org/article/1f137cfed6b04df994fecc21c524491f2017-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-00860-yhttps://doaj.org/toc/2045-2322Abstract Neuromyelitis optica spectrum disorder (NMOSD) is a severe inflammatory autoimmune disease that mainly involves the optic nerves and spinal cord, causing blindness and paralysis. Although some immunosuppressants such as rituximab and azathioprine have proven to be effective in relapse prevention, the high costs or intolerable adverse events preclude their wide application. Thus, we have conducted a retrospective study in 25 NMOSD patients who were treated with tacrolimus, an immunosuppressant with high efficacy and good tolerance in other autoimmune diseases, to assess its efficacy and safety in NMOSD treatment during the last five years (2011–2016). The results revealed that tacrolimus could reduce the relapse rate by 86.2% and improve the Expanded Disability Status Scale (EDSS) scores (4.5 vs 2.3; P < 0.001) significantly. Relapses in tacrolimus treatment were associated with serum titers of aquaporin 4 antibody (AQP4-IgG) (P = 0.028). Further Cox proportional analysis demonstrated that patients with high titers of AQP4-IgG (≥1:64) had a significantly higher risk of relapse than those with low titers after tacrolimus therapy (HR:5.665; CI95: 1.012–31.705; P = 0.048). Tacrolimus tended to be superior to azathioprine (29 patients) in terms of efficacy and safety during the same period. Our study suggests that tacrolimus may be another promising immunosuppressant for NMOSD.Bo ChenQian WuGaotan KeBitao BuNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-8 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Bo Chen Qian Wu Gaotan Ke Bitao Bu Efficacy and safety of tacrolimus treatment for neuromyelitis optica spectrum disorder
description	Abstract Neuromyelitis optica spectrum disorder (NMOSD) is a severe inflammatory autoimmune disease that mainly involves the optic nerves and spinal cord, causing blindness and paralysis. Although some immunosuppressants such as rituximab and azathioprine have proven to be effective in relapse prevention, the high costs or intolerable adverse events preclude their wide application. Thus, we have conducted a retrospective study in 25 NMOSD patients who were treated with tacrolimus, an immunosuppressant with high efficacy and good tolerance in other autoimmune diseases, to assess its efficacy and safety in NMOSD treatment during the last five years (2011–2016). The results revealed that tacrolimus could reduce the relapse rate by 86.2% and improve the Expanded Disability Status Scale (EDSS) scores (4.5 vs 2.3; P < 0.001) significantly. Relapses in tacrolimus treatment were associated with serum titers of aquaporin 4 antibody (AQP4-IgG) (P = 0.028). Further Cox proportional analysis demonstrated that patients with high titers of AQP4-IgG (≥1:64) had a significantly higher risk of relapse than those with low titers after tacrolimus therapy (HR:5.665; CI95: 1.012–31.705; P = 0.048). Tacrolimus tended to be superior to azathioprine (29 patients) in terms of efficacy and safety during the same period. Our study suggests that tacrolimus may be another promising immunosuppressant for NMOSD.
format	article
author	Bo Chen Qian Wu Gaotan Ke Bitao Bu
author_facet	Bo Chen Qian Wu Gaotan Ke Bitao Bu
author_sort	Bo Chen
title	Efficacy and safety of tacrolimus treatment for neuromyelitis optica spectrum disorder
title_short	Efficacy and safety of tacrolimus treatment for neuromyelitis optica spectrum disorder
title_full	Efficacy and safety of tacrolimus treatment for neuromyelitis optica spectrum disorder
title_fullStr	Efficacy and safety of tacrolimus treatment for neuromyelitis optica spectrum disorder
title_full_unstemmed	Efficacy and safety of tacrolimus treatment for neuromyelitis optica spectrum disorder
title_sort	efficacy and safety of tacrolimus treatment for neuromyelitis optica spectrum disorder
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/1f137cfed6b04df994fecc21c524491f
work_keys_str_mv	AT bochen efficacyandsafetyoftacrolimustreatmentforneuromyelitisopticaspectrumdisorder AT qianwu efficacyandsafetyoftacrolimustreatmentforneuromyelitisopticaspectrumdisorder AT gaotanke efficacyandsafetyoftacrolimustreatmentforneuromyelitisopticaspectrumdisorder AT bitaobu efficacyandsafetyoftacrolimustreatmentforneuromyelitisopticaspectrumdisorder
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Efficacy and safety of tacrolimus treatment for neuromyelitis optica spectrum disorder

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