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Long-term safety of azathioprine for treatment of neuromyelitis optica spectrum disorders.
Gomes, Ana Beatriz Ayroza Galvão Ribeiro; Pitombeira, Milena Sales; Sato, Douglas Kazutoshi; Callegaro, Dagoberto; Apóstolos-Pereira, Samira Luisa.
Afiliação
  • Gomes ABAGR; Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.
  • Pitombeira MS; Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.
  • Sato DK; Pontifícia Universidade Católica do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre RS, Brazil.
  • Callegaro D; Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.
  • Apóstolos-Pereira SL; Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.
Arq Neuropsiquiatr ; 79(3): 229-232, 2021 03.
Article em En | MEDLINE | ID: mdl-33729325
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.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neuromielite Óptica Tipo de estudo: Observational_studies Limite: Adult / Female / Humans / Male País/Região como assunto: America do sul / Brasil Idioma: En Revista: Arq Neuropsiquiatr Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neuromielite Óptica Tipo de estudo: Observational_studies Limite: Adult / Female / Humans / Male País/Região como assunto: America do sul / Brasil Idioma: En Revista: Arq Neuropsiquiatr Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha