{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T12:03:56Z","timestamp":1792325036696,"version":"4.4.0"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurol"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Aquaporin-4 neuromyelitis optica spectrum disorder (AQP4-NMOSD) often coexists with other autoimmune diseases (AIDs), whereas such comorbidities are less common in myelin oligodendrocyte glycoprotein antibody disease (MOGAD). This study investigates the impact of additional AIDs on early relapse recovery and disability in patients with AQP4-NMOSD and MOGAD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This retrospective study included patients aged\u2009&gt;\u200916 years with AQP4-NMOSD (<jats:italic>n<\/jats:italic>\u2009=\u2009175) or MOGAD (<jats:italic>n<\/jats:italic>\u2009=\u2009221), who were followed at a nationally commissioned Oxford service and categorized based on the presence of at least one AID. Outcomes included recovery from the onset attack, visual recovery after the first optic neuritis (ON) attack (\u2265\u20096 months post attack), time to first relapse and time to death. Incomplete visual recovery was defined as visual acuity worse than LogMAR 0.1. Optical coherence tomography (OCT) assessed retinal nerve fiber layer thickness and ganglion cell-inner plexiform layer volume in a subset.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>In the AQP4-NMOSD cohort, 28% (<jats:italic>n<\/jats:italic>\u2009=\u200949) had at least one AID, compared to 11.3% (<jats:italic>n<\/jats:italic>\u2009=\u200925) in the MOGAD cohort (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), with thyroid disease constituting the majority of these cases in both groups. In MOGAD, the median age of first attack was significantly higher in the AID group (46 years; IQR: 35\u201356) than in the non-AID group (35 years; IQR: 28\u201347) (<jats:italic>p<\/jats:italic>\u2009=\u20090.004), a difference that was not observed in the AQP4-NMOSD cohort. In both the AQP4-NMOSD (<jats:italic>n<\/jats:italic>\u2009=\u2009175) and the MOGAD (<jats:italic>n<\/jats:italic>\u2009=\u2009221) cohorts, age was a significant predictor of outcome in univariate analyses (AQP4-NMOSD: OR\u2009=\u20090.96 per year, 95% CI: 0.94\u20130.98, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; MOGAD: OR\u2009=\u20090.97 per year, 95% CI: 0.94\u20130.99, <jats:italic>p<\/jats:italic>\u2009=\u20090.008). No significant differences were observed in clinical or visual recovery rates between AID and non-AID patients in either cohort. There were no statistically significant differences observed between AID and non-AID cohorts for clinical or visual recovery outcomes. Similarly, AID status did not influence time to relapse (AQP4-NMOSD: HR\u2009=\u20091.0, 95% CI: 0.63\u20131.58, <jats:italic>p<\/jats:italic>\u2009=\u20090.99; MOGAD: HR\u2009=\u20090.78, 95% CI: 0.40\u20131.52, <jats:italic>p<\/jats:italic>\u2009=\u20090.47) or time to death (AQP4-NMOSD: HR\u2009=\u20090.5, 95% CI: 0.18\u20131.36, <jats:italic>p<\/jats:italic>\u2009=\u20090.28). OCT analysis revealed no significant differences in retinal parameters between AID and non-AID groups in both cohorts.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Additional autoimmune diseases are unlikely to significantly affect clinical or visual outcomes in early attacks in patients with AQP4-NMOSD and MOGAD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00415-025-13180-3","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T14:15:50Z","timestamp":1749564950000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The impact of autoimmune comorbidities on the onset attack recovery in adults with AQP4-NMOSD and MOGAD"],"prefix":"10.1007","volume":"272","author":[{"given":"Sara","family":"Samadzadeh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Francis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Layana","family":"Sani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedemann","family":"Paul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasrin","family":"Asgari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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M\u00f8ller Grant to cover travel and accommodation expenses for this study. [FC] received a European Treatment in Multiple Sclerosis clinical fellowship during the completion of this work. [AF] received a travel grant from Alexion. [FP] reports research grants and speaker honoraria from Bayer, Teva, Genzyme, Merck, Novartis, MedImmune and is member of the steering committee of the OCTIMS study (Novartis), all unrelated to this work. [NA] No COI regarding this work. [MIL] is funded by the NHS (Myasthenia and Related Disorders Service and National Specialised Commissioning Group for Neuromyelitis Optica, UK) and by the University of Oxford, UK. She has been awarded research grants from UK associations for patients with myasthenia and with muscular disorders (Myaware and Muscular Dystrophy UK, respectively) and the University of Oxford. She has received speaker honoraria or travel grants from the Guthy-Jackson Charitable Foundation, argenx and UCB. She serves on scientific or educational advisory boards for argenx, Amgen and UCB. [RG] received support for scientific meetings and courses and honoraria for advisory work from Bayer, Biogen, Merck, Novartis, Jasen, MIAC, UCB. No COI regarding this work. [JP] has received support for scientific meetings and honorariums for advisory work From Merck Serono, Novartis, Chugai, Alexion, Roche, Medimmune, Amgen, Vitaccess, UCB, Mitsubishi, Amplo, Janssen. Grants from Alexion, Argenx, Clene, Roche, Medimmune, Amplo biotechnology. Patent ref P37347WO and licence agreement Numares multimarker MS diagnostics Shares in AstraZenica. Her group has been awarded an ECTRIMS fellowship and a Sumaira Foundation grant to start later this year. A Charcot fellow worked in Oxford 2019\u20132021. She acknowledges partial funding to the trust by Highly specialised services NHS England. She is on the medical advisory boards of the Sumaira Foundation and MOG project charities, Is a member of the Guthy Jackon Foundation Charity and is on the Board of the European Charcot Foundation and a member of MAGNIMS and the UK NHSE IVIG Committee and chairman of the NHSE neuroimmunology patient pathway and ECTRIMS Council member on the educational committee since June 2023. Currently on the ABN advisory groups for MS and neuroinflammation and recently on neuro-muscular diseases advisory group.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval was obtained under Oxfordshire Research Ethics Committee Reference: 21\/SC\/0353.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Written informed consent to participate was obtained.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable (see above ethical consideration and consent to participate).","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}],"article-number":"453"}}