The presence of new asymptomatic MRI lesions among patients with NMOSD during the relapse-free period and at relapses was not associated with a shorter time to developing subsequent relapses.
A recent study in the Multiple Sclerosis journal revealed that asymptomatic MRI lesions are common in neuromyelitis optica spectrum disorder (NMOSD) patients during relapses. This large Latin American cohort study provides valuable real-world insights.
Out of 135 aquaporin-4 immunoglobulin-G (AQP4-IgG)-positive NMOSD patients, 19.26% experienced new asymptomatic MRI lesions during relapse-free periods, and 48.88% during attacks, with optic nerves and short transverse myelitis being the most common. No differences were found between AQP4-IgG-positive and AQP4-IgG-negative patients.
The study, led by Senior Author Juan Ignacio Rojas, MD, from CEMIC University Hospital in Buenos Aires, Argentina, examined 675 NMOSD patient MRIs over at least 2 years. The Kaplan-Meier analysis showed no significant differences in time to develop a new relapse or cumulative hazard risk between patients with and without asymptomatic MRI lesions.
However, the study has limitations due to a small sample size, non-standardized MRI assessments, and the absence of data on immunosuppressant treatment. Further prospective research with larger samples is needed to confirm the relevance of periodic MRIs for NMOSD patients in the era of new immunotherapies.