The quality of life of NMOSD patients corresponds to their degree of disability and can be improved with early interventions for preventing relapse.
Neuromyelitis optical spectrum disorder (NMOSD) is a rare autoimmune disorder involving the spinal cord and optic nerves. There is a consistent and strong association between the quality of life (QoL) and disability of individuals with NMOSD. The study findings from Phase 3 double-blind, randomized, multi-center studies are published in the journal Multiple Sclerosis and Related Disorders.
A High Level of Disability Was Associated With Low Levels of Quality of Life
This analysis revealed that each incremental score increase on the Expanded Disability Status Scale (EDSS) resulted in a decrease in the QoL of NMOSD patients, which was represented by the EuroQol 5-Dimensions (EQ-5D). However, an EDSS score of 2.0–2.5 had a marginally higher mean utility than an EDSS score of 1.0–1.5. Therefore, QoL for a given disability state is governed by the disability instead of the treatment administered to the patient.
The Treatment Group Had a Minimal Effect on EQ-5D Utilities
SAkura studies demonstrated the ability of satralizumab to significantly reduce the risk of relapse in NMOSD patients compared to placebo; however, the studies noted no substantial differences in pain, fatigue, and EQ-5D score as determinants of QoL.
The Study Results Were Limited by Several Factors
The inclusion criteria of the original studies restricted the recruitment of patients to baseline EDSS scores of ≤ 6.5. In addition, the disability of NMOSD patients was limited due to a number of therapeutic measures, including urgent rescue treatment, high vigilance levels for relapses, and effective maintenance therapy, as well as a relatively short follow-up duration.
This analysis established a clear association between health-related QoL and disability measured using EQ-5D and EDSS, respectively. Early relapse prevention contributes to improved long-term QoL of NMOSD patients.
Levy, M., Haycox, A. R., Becker, U., Costantino, C., Damonte, E., Klingelschmitt, G., von Büdingen, H. C., Wallenstein, G., Maio, D. D., & Szczechowski, L. (2022). Quantifying the relationship between disability progression and quality of life in patients treated for NMOSD: Insights from the SAkura studies. Mult Scler Relat Disord, 57, 103332. https://doi.org/10.1016/j.msard.2021.103332