Although they have a lower risk of disease severity than adults with NMOSD, pediatric patients with NMOSD are at a higher risk of relapse attacks, motor deficits, and visual disabilities than their adult counterparts. Using a predictive risk score model may help healthcare professionals pinpoint the timeline of relapse and formulate personalized treatment plans.
Neuromyelitis optica spectrum disorder (NMOSD) is a progressive autoimmune disease that targets spinal cord, optic nerves, and brain or brain stem. Although it can be a damaging CNS demyelinating disease, NMOSD typically presents as less severe in children than in adults. However, children with NMOSD may have a higher risk of relapse and visual damage than adults with NMOSD. Identifying the risk factors for relapse is critical for predicting relapse attacks.
A retrospective analysis published in Frontiers in Immunology obtained and evaluated data on 64 pediatric patients. Researchers constructed a risk score model by extracting independent risk factors during a 1-year follow-up. Multivariate logistic analysis was used to investigate independent risk factors related to relapse attacks. Researchers also generated a nomogram to assess relapse attacks in the 1-year follow-up.
Independent risk factors related to relapse attacks were identified including Expanded Disability Status Scale (EDSS) scores at discharge, mixed-lesion onset, autoantibody counts, and the use of maintenance therapy, such as tapering steroids with mycophenolate mofetil, acetazolamide, or no concomitant therapy. The risk score model provided accurate predicted relapse estimates, and the nomogram exhibited predictive risk improvement better than other factors across all cohort groups.
Using the risk score and nomogram presented in this retrospective analysis may prove valuable for clinicians to accurately identify relapse risk in pediatric patients with NMOSD. Clinicians should make use of predictive risk factor score models to devise a personalized treatment regimen for pediatric patients who may be at risk of NMOSD relapse and disability [1].
Source:
[1] Zhang, S., Qiao, S., Li, H., Zhang, R., Wang, M., Han, T., Liu, X., & Wang, Y. (2022). Risk factors and nomogram for predicting relapse risk in pediatric neuromyelitis optica spectrum disorders. Frontiers in Immunology, 13. https://doi.org/10.3389/fimmu.2022.765839
