Understanding Treatment Decisions in Neuromyelitis Optica Spectrum Disorder: A Global Clinical Record Review with Patient Interviews
Journal: Neurology and Therapy; February 24, 2023
Author(s): Ju-Hong Min, Marco Capobianco, Carly Welsh, Patricia Lobo, Gabrielle deFiebre, Marco Lana-Peixoto, Dean M. Wingerchuk, Jiawei Wang, Marius Ringelstein
NMOSD management in real-life settings globally
This study evaluated treatment practices for NMOSD globally by conducting an online survey among 389 neurologists in the USA, Germany, Italy, Brazil, South Korea, and China (representing data from 1185 patients) and conducting telephonic interviews with 33 patients receiving maintenance therapy for NMOSD. Questions to neurologists captured patient demographics, diagnosis, maintenance treatment history, relapse occurrence, and disease severity. Patient interviews covered diagnosis, treatment, perceptions about relapse severity or disease stability, and switching from one treatment to another. About 25% of the patients were initially misdiagnosed, resulting in delayed treatment and more relapses compared to patients who received the correct initial diagnosis. Oral corticosteroids or immunosuppressants were typically the first treatment given in all countries, except in the USA, where monoclonal antibodies were also equally likely to be used as the first treatment. The decision to switch treatments was usually made by neurologists based on the severity of relapses. Most patients interviewed did not recall being offered a choice of treatment or understand why they were prescribed a certain treatment. A related study used the same neurologist survey and patient interviews to characterize how disease severity and stability are classified globally.
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