Use of Rituximab and Risk of Re-hospitalization for Children with Neuromyelitis Optica Spectrum Disorder

Multiple Sclerosis and Demyelinating Disorders
Sabrina GmucaJeffrey S Gerber

Abstract

Treatment algorithms for neuromyelitis optica spectrum disorder (NMOSD) vary, and sparse data exist regarding the impact of initial treatments on disease course. We aimed to determine whether administration of rituximab during first hospitalization reduces 1-year readmission rates. We conducted a retrospective cohort study of subjects with NMOSD using the Pediatric Health Information System database from 2005-2015. Subjects were ages 1 to 21 years who received glucocorticoids and an ICD-9-CM code indicating neuromyelitis optica (NMO) during first hospitalization. All subjects had at least 12 months of continuous enrollment. The primary exposure was ≥1 rituximab dose during first hospitalization. We tested for the association of rituximab use with all-cause re-hospitalization, the primary outcome, using survival analysis. Re-hospitalization was considered if a hospital admission occurred > 30 days after initial discharge with exclusion of admissions with re-dosing of rituximab and data were censored at 12 months. Secondary outcomes included time to and median duration of re-hospitalization using 25th percentiles of survival time and the Wilcoxon-rank sum test, respectively. Of 180 subjects who met inclusion criteria, 71.7% were ...Continue Reading

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Mar 4, 2020·Current Neurology and Neuroscience Reports·Ryan A Gise, Gena Heidary
Oct 24, 2020·Nature Reviews. Disease Primers·Sven JariusBrigitte Wildemann

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