{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T16:21:59Z","timestamp":1776356519776,"version":"3.51.2"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T00:00:00Z","timestamp":1610668800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> To investigate the remedial efficacy and safety of intravenous cyclophosphamide (CP) in the acute phase in patients with neuromyelitis optica spectrum disorder-related optic neuritis (NMOSD-ON) who are refractory to intravenous methylprednisolone (MP) treatment.<\/jats:p><jats:p><jats:bold>Design:<\/jats:bold> This study was a single-center, retrospective, observational case-control cohort study.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Thirty-six patients who had acute NMOSD-ON attacks and were refractory to MP treatment were included. Patents were divided into two groups: the remedial CP group, and the MP group. The best-corrected visual acuity (BCVA), mean deviation (MD) of the visual field (VF), visual evoked potential amplitude (VEP-A), visual evoked potential latency (VEP-T), and average thickness of the retinal nerve fiber layer (RNFL) at onset, 1 month (m), 3 m, and 6 m after the attack were analyzed. Routine blood test results, liver and kidney function, routine urinalysis results and general condition were analyzed for safety issues at each follow-up. Fisher's exact test, the Mann-Whitney U test, the Kruskal-Wallis test and the Wilcoxon rank-sum test were used for statistical analysis.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The remedial CP group showed significant improvement over 6 m with regard to BCVA and MD (<jats:italic>P<\/jats:italic> &amp;lt; 0.05),whereas MP group only showed significant improvement in MD (<jats:italic>P<\/jats:italic> &amp;lt; 0.05). Regarding remedial CP intervention time window, the CP  \u2264  30 days group showed significant improvement over 6 m with regard to BCVA (<jats:italic>P<\/jats:italic> = 0.002), MD (<jats:italic>P<\/jats:italic> = 0.003), and VEP-A (<jats:italic>P<\/jats:italic> = 0.036), while those CP &amp;gt; 30 days group did not. Both two subgroups showed significantly RNFL thickness reduction, however, BCVA, MD, VEP-A, VEP-T, and RNFL thickness showed no significant differences between the two subgroups at any follow-up point (<jats:italic>P<\/jats:italic> &amp;gt; 0.05).<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> CP within 30 days of attack onset is safe and might have a beneficial degree of therapeutic efficacy for acute-phase treatment of NMOSD-ON that is refractory to MP treatment alone.<\/jats:p>","DOI":"10.3389\/fneur.2020.612097","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T15:42:31Z","timestamp":1610725351000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Remedial Effect of Intravenous Cyclophosphamide in Corticosteroid-Refractory Patients in the Acute Phase of Neuromyelitis Optica Spectrum Disorder-Related Optic Neuritis"],"prefix":"10.3389","volume":"11","author":[{"given":"Ling","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaiqun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuxin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoning","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Fu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,1,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1016\/j.mayocp.2016.12.014","article-title":"Neuromyelitis spectrum disorders","volume":"92","author":"Weinshenker","year":"2017","journal-title":"Mayo Clin Proc."},{"key":"B2","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1056\/NEJMoa1900866","article-title":"Eculizumab in aquaporin-4-positive neuromyelitis optica spectrum disorder","volume":"381","author":"Pittock","year":"2019","journal-title":"N Engl J Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1007\/s00296-018-3995-3","article-title":"Comparing the efficacy of low-dose vs high-dose cyclophosphamide regimen as induction therapy in the treatment of proliferative lupus nephritis: a single center study","volume":"38","author":"Mehra","year":"2018","journal-title":"Rheumatol Int."},{"key":"B4","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1186\/s12883-014-0200-5","article-title":"Sj\u00f6gren's syndrome and neuromyelitis optica spectrum disorders (NMOSD) - 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