{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:39:15Z","timestamp":1777937955655,"version":"3.51.4"},"reference-count":44,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100002429","name":"Amgen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002429","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Financial toxicity (FT) and the social determinants of health (SDOH) remain underexplored in neuromyelitis optica spectrum disorder (NMOSD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To characterize FT in NMOSD and examine sociodemographic and clinical features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a convenience-sampled, cross-sectional, anonymous survey (08\/2024\u201303\/2025) of 124 U.S. adults. The COmprehensive Score for financial Toxicity (COST) was used to measure FT (lower COST\u2009=\u2009higher FT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Seventy-five percent had a COST\u2009&lt;\u200925 points, consistent with FT. In multivariable analysis, a higher attack frequency was associated with a 1.20-point lower COST score (95% confidence interval [CI] \u20131.90, \u20130.50), and each one-unit increase in disability, as measured by the Patient-Determined Disease Steps, was associated with a 0.80-point lower COST (95% CI \u20131.40, \u20130.20). Non-White race was associated with a 3.50-point lower COST (95% CI \u20135.80, \u20131.20), and double-seronegative antibody status with a 2.80-point lower COST (95% CI \u20135.00, \u20130.60). Mediation analysis suggested the effects of disability and race on FT are partially attributable to income.<\/jats:p>\n                    <jats:p>In exploratory models with attack count as the outcome, each one-point higher COST (lower FT) was associated with a 0.043-attack decrease (95% CI \u20130.081, \u20130.005).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Financial toxicity is highly prevalent in NMOSD and associated with key clinical and sociodemographic features. There is a need for comprehensive NMOSD care models that address financial strain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585251365139","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T07:38:29Z","timestamp":1757403509000},"page":"1370-1380","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Characterizing financial toxicity among people living with neuromyelitis optica spectrum disorder"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3319-610X","authenticated-orcid":false,"given":"Justin B","family":"Hill","sequence":"first","affiliation":[{"name":"Department of Neurology, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3757-1587","authenticated-orcid":false,"given":"Maya L","family":"Mastick","sequence":"additional","affiliation":[{"name":"Department of Neurology, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5233-7754","authenticated-orcid":false,"given":"Horacio","family":"Chiong-Rivero","sequence":"additional","affiliation":[{"name":"Department of Neurology, Anne Burnett Marion School of Medicine, Texas Christian University, Fort Worth, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4255-9617","authenticated-orcid":false,"given":"Elena","family":"Grebenciucova","sequence":"additional","affiliation":[{"name":"Department of Neurology, Northwestern University, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4293-8115","authenticated-orcid":false,"given":"Farrah J","family":"Mateen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurological Clinical Research Institute, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Mayo Clinic. 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