Long-term safety of azathioprine for treatment of neuromyelitis optica spectrum disorders
ABSTRACT Background: Azathioprine is a common first-line therapy for neuromyelitis optica spectrum disorder (NMOSD). Objective: The aim of this study was to determine whether long-term treatment (>10 years) with azathioprine is safe in NMOSD. Methods: We conducted a retrospective medical reco...
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Thieme Revinter Publicações
2021-03-01
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| Series: | Arquivos de Neuro-Psiquiatria |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000300229&tlng=en |
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| author | Ana Beatriz Ayroza Galvão Ribeiro GOMES Milena Sales PITOMBEIRA Douglas Kazutoshi SATO Dagoberto CALLEGARO Samira Luisa APÓSTOLOS-PEREIRA |
| author_facet | Ana Beatriz Ayroza Galvão Ribeiro GOMES Milena Sales PITOMBEIRA Douglas Kazutoshi SATO Dagoberto CALLEGARO Samira Luisa APÓSTOLOS-PEREIRA |
| author_sort | Ana Beatriz Ayroza Galvão Ribeiro GOMES |
| collection | DOAJ |
| description | ABSTRACT Background: Azathioprine is a common first-line therapy for neuromyelitis optica spectrum disorder (NMOSD). Objective: The aim of this study was to determine whether long-term treatment (>10 years) with azathioprine is safe in NMOSD. Methods: We conducted a retrospective medical record review of all patients at the School of Medicine of the University of São Paulo (São Paulo, Brazil) who fulfilled the 2015 international consensus diagnostic criteria for NMOSD and were treated with azathioprine for at least 10 years. Results: Out of 375 patients assessed for eligibility, 19 were included in this analysis. These patients’ median age was 44 years (range=28-61); they were mostly female (17/19) and AQP4-IgG seropositive (18/19). The median disease duration was 15 years (range=10-39) and most patients presented a relapsing clinical course (84.2%). The median duration of treatment was 11.9 years (range=10.0-23.8). The median annualized relapse rates (ARR) pre- and post-treatment with azathioprine were 1 (range=0.1-2) and 0.1 (range=0-0.35); p=0.09. Three patients (15.7%) had records of adverse events during the follow-up, which consisted of chronic B12 vitamin deficiency, pulmonary tuberculosis and breast cancer. Conclusion: Azathioprine may be considered a safe agent for long-term treatment (>10 years) of NMOSD, but continuous vigilance for infections and malignancies is required. |
| format | Article |
| id | doaj-art-b0ec3ccace3e4dcbbd0081aab69f1dcd |
| institution | Kabale University |
| issn | 1678-4227 |
| language | English |
| publishDate | 2021-03-01 |
| publisher | Thieme Revinter Publicações |
| record_format | Article |
| series | Arquivos de Neuro-Psiquiatria |
| spelling | doaj-art-b0ec3ccace3e4dcbbd0081aab69f1dcd2025-08-20T03:39:25ZengThieme Revinter PublicaçõesArquivos de Neuro-Psiquiatria1678-42272021-03-0179322923210.1590/0004-282x-anp-2020-0041Long-term safety of azathioprine for treatment of neuromyelitis optica spectrum disordersAna Beatriz Ayroza Galvão Ribeiro GOMEShttps://orcid.org/0000-0003-1657-6891Milena Sales PITOMBEIRAhttps://orcid.org/0000-0002-3298-0264Douglas Kazutoshi SATOhttps://orcid.org/0000-0002-7695-6020Dagoberto CALLEGAROhttps://orcid.org/0000-0003-0077-173XSamira Luisa APÓSTOLOS-PEREIRAhttps://orcid.org/0000-0003-3493-1199ABSTRACT Background: Azathioprine is a common first-line therapy for neuromyelitis optica spectrum disorder (NMOSD). Objective: The aim of this study was to determine whether long-term treatment (>10 years) with azathioprine is safe in NMOSD. Methods: We conducted a retrospective medical record review of all patients at the School of Medicine of the University of São Paulo (São Paulo, Brazil) who fulfilled the 2015 international consensus diagnostic criteria for NMOSD and were treated with azathioprine for at least 10 years. Results: Out of 375 patients assessed for eligibility, 19 were included in this analysis. These patients’ median age was 44 years (range=28-61); they were mostly female (17/19) and AQP4-IgG seropositive (18/19). The median disease duration was 15 years (range=10-39) and most patients presented a relapsing clinical course (84.2%). The median duration of treatment was 11.9 years (range=10.0-23.8). The median annualized relapse rates (ARR) pre- and post-treatment with azathioprine were 1 (range=0.1-2) and 0.1 (range=0-0.35); p=0.09. Three patients (15.7%) had records of adverse events during the follow-up, which consisted of chronic B12 vitamin deficiency, pulmonary tuberculosis and breast cancer. Conclusion: Azathioprine may be considered a safe agent for long-term treatment (>10 years) of NMOSD, but continuous vigilance for infections and malignancies is required.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000300229&tlng=enAzathioprineNeuromyelitis OpticaTherapeutics |
| spellingShingle | Ana Beatriz Ayroza Galvão Ribeiro GOMES Milena Sales PITOMBEIRA Douglas Kazutoshi SATO Dagoberto CALLEGARO Samira Luisa APÓSTOLOS-PEREIRA Long-term safety of azathioprine for treatment of neuromyelitis optica spectrum disorders Arquivos de Neuro-Psiquiatria Azathioprine Neuromyelitis Optica Therapeutics |
| title | Long-term safety of azathioprine for treatment of neuromyelitis optica spectrum disorders |
| title_full | Long-term safety of azathioprine for treatment of neuromyelitis optica spectrum disorders |
| title_fullStr | Long-term safety of azathioprine for treatment of neuromyelitis optica spectrum disorders |
| title_full_unstemmed | Long-term safety of azathioprine for treatment of neuromyelitis optica spectrum disorders |
| title_short | Long-term safety of azathioprine for treatment of neuromyelitis optica spectrum disorders |
| title_sort | long term safety of azathioprine for treatment of neuromyelitis optica spectrum disorders |
| topic | Azathioprine Neuromyelitis Optica Therapeutics |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000300229&tlng=en |
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