{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T15:46:51Z","timestamp":1783352811726,"version":"3.54.6"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007194","name":"Wenzhou Municipal Science and Technology Bureau","doi-asserted-by":"publisher","award":["Y20210168"],"award-info":[{"award-number":["Y20210168"]}],"id":[{"id":"10.13039\/501100007194","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the effectiveness of high\u2010efficacy treatments (HET) and low\u2010efficacy treatments (LET) in NMOSD patients with anti\u2010aquaporin\u20104 antibodies (AQP4\u2010ab).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this multi\u2010center study, we analyzed 183 AQP4\u2010ab seropositive NMOSD patients who received immunosuppressive treatments (IST). Primary outcomes included annualized relapse rate (ARR) and Expanded Disability Status Scale (EDSS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 86 HET and 143 LET treatment episodes were included. Patients with HET had the lower relapse rate (41.9% vs. 59.4%, <jats:italic>p<\/jats:italic>\u2009=\u20090.015). At the final follow\u2010up, the HET group had lower ARR (<jats:italic>p<\/jats:italic>\u2009=\u20090.003) and EDSS (<jats:italic>p<\/jats:italic>\u2009=\u20090.004) compared to LET. HET (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, adjusted <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), early IST initiation after onset (<jats:italic>p<\/jats:italic>\u2009=\u20090.007, adjusted <jats:italic>p<\/jats:italic>\u2009=\u20090.008) and younger age of onset (<jats:italic>p<\/jats:italic>\u2009=\u20090.024, adjusted <jats:italic>p<\/jats:italic>\u2009=\u20090.028) were the protective factors for high EDSS, and HET (HR: 0.66, 95% CI: 0.44\u20130.99, <jats:italic>p<\/jats:italic>\u2009=\u20090.047) prolonged the remission after IST. Meantime, Anderson\u2010Gill analysis indicated that HET is associated with a lower risk of relapse (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). After PSM, patients receiving HET had significantly reduced ARR (<jats:italic>p<\/jats:italic>\u2009=\u20090.046) and EDSS scores (<jats:italic>p<\/jats:italic>\u2009=0.030) compared to those receiving LET.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Our findings indicated the superior efficacy in reducing neurological disability and relapse risk of HET in AQP4\u2010ab seropositive NMOSD patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.70128","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T04:34:54Z","timestamp":1751430894000},"page":"1983-1991","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["High\u2010Efficacy Treatment in Neuromyelitis Optica Specturm Disorder Patients With Seropositive <scp>AQP4<\/scp> Antibodies\u2014A Real\u2010World Study"],"prefix":"10.1002","volume":"12","author":[{"given":"Xiang","family":"Li","sequence":"first","affiliation":[{"name":"Department of Neurology The First Affiliated Hospital of Wenzhou Medical University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binbin","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology The First Affiliated Hospital of Wenzhou Medical University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology The First Affiliated Hospital of Wenzhou Medical University  Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dewei","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Neurology The First Affiliated Hospital of Wenzhou Medical University  Wenzhou 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