Relationship Between Life Quality and Disability Progression in NMOSD Patients

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.

Source:

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

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