{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T21:36:30Z","timestamp":1789076190462,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,6,11]],"date-time":"2022-06-11T00:00:00Z","timestamp":1654905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81771300"],"award-info":[{"award-number":["81771300"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81901229"],"award-info":[{"award-number":["81901229"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Preventing relapse by immunosuppressants (ISs) is critical for the prognosis of neuromyelitis optica spectrum disorder (NMOSD); however, the optimal duration of IS treatment is still under discussion. The objective was to explore the optimal duration of IS treatment and the risk of IS discontinuation for NMOSD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This cohort study was conducted at a major neurological center that housed the largest NMOSD database in South China. Eligible participants were patients with NMOSD undergoing IS treatment. The main outcome measures were changes in relapse risk based on IS treatment duration, clinical outcomes and predictors of relapse following IS discontinuation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 343 patients were included in this study. The duration of IS treatment was strongly associated with a decrease in relapse risk (hazard ratio [HR] 0.53, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Continuous IS treatment resulted in decreased relapse HRs within 5\u2009years of receiving IS medication, with a mild rebound starting at 5\u2009years. Rituximab reduced the risk of NMOSD relapse to approximately zero within 3\u2009years. The rate of relapse after IS withdrawal was high (77.5%). As opposed to other ISs, a delayed relapse following rituximab withdrawal was observed in this study. Longitudinal extensive transverse myelitis (HR\u00a0=\u00a02.023, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.006) was associated with a higher risk of relapse after IS discontinuation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Long\u2010term IS medication for NMOSD is generally suitable. Patients with longitudinal extensive transverse myelitis had a higher risk of relapse after IS discontinuation. Future studies should explore individualized strategies of rituximab maintenance treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15425","type":"journal-article","created":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T08:44:42Z","timestamp":1653986682000},"page":"2792-2800","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Immunosuppressant and neuromyelitis optica spectrum disorder: optimal treatment duration and risk of discontinuation"],"prefix":"10.1111","volume":"29","author":[{"given":"Rui","family":"Li","sequence":"first","affiliation":[{"name":"Department of Neurology Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"},{"name":"Department of Neurology Zhongda Hospital of Southeast University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiao","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurology Zhaoqing No. 2 People's Hospital  Zhaoqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zifeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Clinical Data Center Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Chen","sequence":"additional","affiliation":[{"name":"Clinical Data Center Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingjun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1017-2554","authenticated-orcid":false,"given":"Yaqing","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Neurology Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuge","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4476-4016","authenticated-orcid":false,"given":"Allan G.","family":"Kermode","sequence":"additional","affiliation":[{"name":"Department of Neurology Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"},{"name":"Centre for Neuromuscular and Neurological Disorders, Department of Neurology, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre University of Western Australia  Perth WA Australia"},{"name":"Institute of Immunology and Infectious Diseases Murdoch University  Perth WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0880-958X","authenticated-orcid":false,"given":"Wei","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Neurology Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2016-313300"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30392-6"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/460825"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2020.117225"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11940-010-0071-z"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11940-008-0007-z"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458519832249"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458519829694"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/NRL.0000000000000095"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000947"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001729"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2017-315603"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2019.101868"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000640"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073814553974"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2016.02.014"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458513515085"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.19-2-169"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000603"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.15425","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ene.15425","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.15425","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T08:57:56Z","timestamp":1692608276000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.15425"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,11]]},"references-count":19,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1111\/ene.15425"],"URL":"https:\/\/doi.org\/10.1111\/ene.15425","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,11]]},"assertion":[{"value":"2022-04-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}