{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T10:58:03Z","timestamp":1775386683973,"version":"3.50.1"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"11","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":95,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Neuropsiquiatr"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Double-seronegative neuromyelitis optica spectrum disorder (DS-NMOSD) encompasses a heterogeneous spectrum, including monophasic and relapsing phenotypes. While 1\/3 patients may follow a monophasic course, lifelong immunotherapy remains common practice due to the fear of relapse. However, this strategy may unnecessarily expose stable patients to long-term adverse effects and economic burden. The condition lacks the relapse-associated mechanisms observed in aquaporin 4 (AQP4)-positive disease, questioning the generalizability of prior treatment-withdrawal studies. Although predictive markers for relapse are still lacking, the median time to relapse is of approximately 3.4 (range: 0\u20137) years; hence, sustained remission beyond 10 years may indicate a subgroup of patients with low relapse risk. Until prospective data are available, individualized, cautious treatment interruption should be considered, guided by shared decision-making.<\/jats:p>","DOI":"10.1055\/s-0045-1814371","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T23:59:31Z","timestamp":1770249571000},"page":"001-003","source":"Crossref","is-referenced-by-count":2,"title":["Double-seronegative neuromyelitis optica: it is possible to interrupt treatment after 10 years of stability"],"prefix":"10.1055","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9764-3763","authenticated-orcid":false,"given":"Guilherme Diogo","family":"Silva","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo, Faculdade de Medicina, Hospital das Cl\u00ednicas, Divis\u00e3o de Neurologia, Grupo de Neuroimunologia, S\u00e3o Paulo SP, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1177\/13524585231199819","article-title":"Double-negative neuromyelitis optica spectrum disorder","volume":"29","author":"Y Wu","year":"2023","journal-title":"Mult Scler"},{"issue":"07","key":"ref2","doi-asserted-by":"publisher","first-page":"S36","DOI":"10.1212\/01.wnl.0001051184.20527.af","article-title":"Characterizing double-negative neuromyelitis optica spectrum disorder: A systematic review and meta-analysis","volume":"103","author":"A Malvaso","year":"2024","journal-title":"Neurology"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"104730","DOI":"10.1016\/j.msard.2023.104730","article-title":"Neuromyelitis optica spectrum disorders with a benign course. 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