Table 5.
Risk factors of relapse using univariate and multivariate logistic regressions in 1-year follow-up.
| Variable | Univariate analysis | Multivariate analysis (model 1) | Multivariate analysis (model 2) | |||
|---|---|---|---|---|---|---|
| OR (95% CI) | p-Value | OR (95% CI) | p-Value | OR (95% CI) | p-Value | |
| Gender | ||||||
| Female | 0.754 (0.274–2.072) | 0.584 | ─ | ─ | ─ | ─ |
| Male | Ref | ─ | ─ | ─ | ─ | |
| Age | 0.932 (0.824–1.055) | 0.266 | ─ | ─ | ─ | ─ |
| Antibody status | ||||||
| AQP4 antibody positive | 0.440 (0.158–1.227) | 0.117 | ─ | ─ | ─ | ─ |
| AQP4 antibody negative | Ref | ─ | ─ | ─ | ─ | |
| ARR Pretreatment | 1.040 (0.347–3.116) | 0.944 | ─ | ─ | ─ | ─ |
| Visual disability at onset | ||||||
| Yes | 0.761 (0.219–2.645) | 0.667 | ─ | ─ | ─ | ─ |
| No | Ref | ─ | ─ | ─ | ─ | |
| Pretreatment EDSS | 1.437 (1.124–1.837) | 0.004** | ─ | ─ | ─ | ─ |
| Discharge EDSS | 1.698 (1.173–2.456) | 0.005** | 2.100 (1.143–3.859) | 0.017** | ─ | ─ |
| Attack at onset | ||||||
| ON | ||||||
| Yes | 0.848 (0.311–2.317) | 0.749 | ─ | ─ | ─ | ─ |
| No | Ref | ─ | ─ | ─ | ─ | |
| TM | ||||||
| Yes | 1.941 (0.667–5.658) | 0.224 | ─ | ─ | ─ | ─ |
| No | Ref | ─ | ─ | ─ | ─ | |
| Brain/brainstem | ||||||
| Yes | 17.182 (2.093–141.070) | 0.008** | ─ | ─ | ─ | ─ |
| No | Ref | ─ | ─ | ─ | ─ | |
| Mixed lesion# | ||||||
| Yes | 6.706 (1.932–23.276) | 0.003** | 11.348 (1.773–72.625) | 0.010* | ─ | ─ |
| No | Ref | Ref | ─ | ─ | ||
| Serum AQP4/MOG antibody titer | ||||||
| ≥1:32 | 2.095 (0.767–5.722) | 0.149 | ─ | ─ | ─ | ─ |
| <1:32 or negative | Ref | ─ | ─ | ─ | ─ | |
| Counts of concomitant autoantibodies§ | ||||||
| ≥1 | 5.489 (1.869–16.122) | 0.002** | 7.733 (1.500–39.873) | 0.015* | ─ | ─ |
| <1 | Ref | Ref | ─ | ─ | ||
| Counts of concomitant autoantibodies§ | ||||||
| ≥2 | 1.040 (0.347–3.116) | 0.944 | ─ | ─ | ─ | ─ |
| <2 | Ref | ─ | ─ | ─ | ─ | |
| CSF protein | 0.875 (0.116–6.623) | 0.897 | ─ | ─ | ─ | ─ |
| CSF white cell count | 0.995 (0.984–1.007) | 0.428 | ─ | ─ | ─ | ─ |
| CSF IgG | 1.001 (0.988–1.012) | 0.935 | ─ | ─ | ─ | ─ |
| CSF IgM | 0.984 (0.876–1.105) | 0.785 | ─ | ─ | ─ | ─ |
| Acute therapy | ||||||
| High-dose steroid + IVIg | 1.600 (0.409–6.114) | 0.492 | ─ | ─ | ─ | ─ |
| IVIg | 3.200 (0.419–24.417) | 0.262 | ─ | ─ | ─ | ─ |
| High-dose steroid | 0.667 (0.145–3.075) | 0.603 | ─ | ─ | ─ | ─ |
| Not with high-dose steroid/optimal IVIg | Ref | ─ | ─ | ─ | ─ | |
| Maintenance therapy | ||||||
| Tapering steroid+MMF | 0.077 (0.007–0.901) | 0.041* | 0.017 (0.001–0.369) | 0.009** | ─ | ─ |
| Tapering steroid+AZA | 0.038 (0.004–0.408) | 0.007** | 0.060 (0.004–0.939) | 0.045* | ─ | ─ |
| Tapering steroid only | 0.200 (0.053–0.749) | 0.017* | 0.098 (0.013–0.749) | 0.025* | ─ | ─ |
| Inadequate treatment | Ref | Ref | ||||
| PB B cell count | 1.003 (0.964–1.042) | 0.899 | ─ | ─ | ─ | ─ |
| PB NK cell count | 0.983 (0.938–1.031) | 0.484 | ─ | ─ | ─ | ─ |
| PB CD4+ cell count | 1.019 (0.971–1.068) | 0.443 | ─ | ─ | ─ | ─ |
| PB CD8+ cell count | 1.018 (0.955–1.086) | 0.583 | ─ | ─ | ─ | ─ |
| PB CD4+/CD8+ | 1.011 (0.483–2.116) | 0.977 | ─ | ─ | ─ | ─ |
| Risk score | 2.576 (1.640–4.044) | <0.001** | ─ | ─ | 2.560 (1.060–6.183) | 0.037* |
NMOSD, neuromyelitis optica spectrum disorder; AQP4, aquaporin-4; MOG, myelin oligodendrocyte glycoprotein; ON, optic neuritis; TM, transverse myelitis; EDSS, Expanded Disability Status Scale; IVIg, intravenous immunoglobulin; MMF, mycophenolate mofetil; AZA, azathioprine.
*p < 0.05; **p < 0.01; ***p < 0.001.
§Including antinuclear antibody, extractable nuclear antigen antibody, double-stranded DNA antibody, antineutrophil cytoplasmic antibody, anticardiolipin antibody, Sjögren’s syndrome A antibody, Sjögren’s syndrome B antibody, rheumatoid factor, anti-oipA antibody, thyroglobulin antibody, and thyroid peroxidase antibody.
#Including ON+TM, ON+cerebrum/brainstem, TM+cerebrum/brainstem, and ON+TM+cerebrum/brainstem.