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We aimed to examine relapse-related outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a nationwide historically prospective AQP4-Ab\u2009+\u2009NMOSD cohort, relapse outcomes, relapse and maintenance treatments were analyzed by mixed-effects linear and logistic regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among sixty-six patients (median follow-up: 99.5 months) there were 350 relapses and 272 relapse treatments. Delayed immunosuppression after the first relapse and brainstem (BS) relapses were associated with higher Expanded Disability Status Scale (EDSS) scores at final follow-up. Optic neuritis (ON) was associated with higher relapse frequency. Higher age and male sex were associated with more severe transverse myelitis (TM) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.032), and male sex was also associated with worse ON recovery (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.036). ON was more likely after TM (OR: 3.2, 95% CI: 1.7-6.0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and vice versa (OR: 2.9, 95% CI: 1.6\u20135.2;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). BS relapse was also more likely after TM (OR: 2.8, 95% CI: 1.2\u20136.4;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016) and vice versa (OR: 2.4; 95% CI: 1.1\u20135.3;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031). Rituximab treatment correlated with lower EDSS score at final follow-up (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.044).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Earlier initiation of immunosuppressive maintenance treatment limited the accumulation of disability in NMOSD. Recognizing relapse patterns could aid in tailoring monitoring and treatment choices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10072-025-08754-y","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T07:13:29Z","timestamp":1768288409000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Relapse-related outcomes in the Danish population-based AQP4- antibody seropositive neuromyelitis optica spectrum disorder cohort"],"prefix":"10.1007","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3140-4983","authenticated-orcid":false,"given":"Sepehr","family":"Mamoei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f6ren","family":"M\u00f6ller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda","family":"Magyari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Finn","family":"Sellebjerg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jette L.","family":"Frederiksen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina B.","family":"Svendsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasha","family":"Saleem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helle B.","family":"S\u00f8ndergaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna C.","family":"Nilsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktoria","family":"Papp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsolt","family":"Illes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"issue":"7","key":"8754_CR1","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1056\/NEJMra1904655","volume":"387","author":"DM Wingerchuk","year":"2022","unstructured":"Wingerchuk DM, Lucchinetti CF (2022) Neuromyelitis optica spectrum disorder. 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The Danish Health and Medicines Authority waived the requirement for patient informed consent (file no.: 21\/8187).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical statement"}},{"value":"Viktoria Papp received travel grants from Merck and Sanofi and received research support from Roche. Finn Sellebjerg has served on scientific advisory boards for, served as consultant for, received support for congress participation or received speaker honoraria from Alexion, Biogen, Bristol Myers Squibb, Lundbeck, Merck, Novartis, Roche, and Sanofi Genzyme. His laboratory has received research support from Biogen, Merck, Novartis, Roche, and Sanofi Genzyme. Zsolt Illes received speakers\u2019 honoraria and\/or research grants from Biogen, Roche, Sanofi, Novartis, Merck, Alexion, Bristol Myers Squibb, Lundbeckfonden, Jascha Fonden, Scleroseforeningen, has been member of advisory boards at Alexion, Biogen, Sanofi, Merck, Roche, Novartis, has been member of adjudication relapse (clinical endpoint) committees in phase 3 trials, and has been principal investigator in studies sponsored by Biogen, Merck, and Sanofi. Melinda Magyari has served on scientific advisory board, as consultant for, received support for congress participation or speaker honoraria from Biogen, Sanofi, Roche, Novartis, Merck, Alexion, Bristol Myers Squibb. Sepehr Mamoei, Helle B. S\u00f8ndergaard, Rasha Saleem, Anna C. Nilsson and S\u00f6ren M\u00f6ller have nothing to declare. Kristina B. Svendsen served as a consultant for Takeda and Merck, received travel grants from TEVA, Biogen, Merck, Sanofi and Novartis, and has been principal investigator in studies sponsored by Alexion, Roche, Sanofi, Novartis, and Amgen. Jette Frederiksen has received no funding to support the presented work. She has served on scientific advisory boards for and received funding for travel related to these activities as well as honoraria from Merck Serono, Sanofi-Aventis, Novartis, Alexion, and Neuraxpharm.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"158"}}