Efficacy and tolerability of intravenous immunoglobulin versus intravenous methylprednisolone treatment in anti- N-methyl-D-aspartate receptor encephalitis.
机构：[1]Department of Neurology, West China Hospital, Sichuan University, Chengdu, China四川大学华西医院[2]Institute of Brain Science and Brain-Inspired Technology of West China Hospital, Sichuan University, Chengdu, China[3]Department of Neurology, Chengdu Shangjin Nanfu Hospital, Chengdu, China[4]Department of Pediatric West China Second Hospital Sichuan University, Chengdu, China[5]Department of Neurology, Sichuan Provincial Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China四川省人民医院
To compare the effectiveness and safety of intravenous immunoglobulin (IVIg) or intravenous methylprednisolone (IVMP) vs and IVIg plus IVMP (IPI) as initial therapy in anti- N-methyl-D-aspartate receptor (NMDAR) encephalitis.A multicenter study of prospectively identified NMDAR encephalitis individuals who presented from October, 2011, to August, 2020, to the study hospitals of western China, with a median follow-up of 3.9 years. Prespecified candidate variables were the prescriptions of IVIg, IVMP, or a combination of both. Propensity score matching was also performed to control potential confounders.A total of 347 NMDAR encephalitis patients were finally analyzed in this study. After the TriMatch for NMDAR encephalitis, 37 triplets were generated. Compared to IVIg or IVMP, the administration of IPI exhibited a significant benefit of a higher response rate (86.5% vs. 55.6% vs. 68.7%, pcorr <0.01); improved mRS score at 3, 6, and 12 months (pcorr <0.05); and reduced further recurrence rate (10 of 37 [27.0%] vs 9 of 37 [24.3%] vs 2 of 37 [5.4%]; p log rank = 0.01). There was no association between treatment superiority and patient sex or the presence of tumors (p≥0.05). Patients treated with IVMP had a significantly higher number of adverse events, but 99% of adverse events were mild to moderate and did not lead to a change in treatment.In patients with NMDAR encephalitis, adequate response, favorable outcome, and less recurrence were each more likely to occur in individuals treated with a combined immunotherapy than in monotherapy individuals.This article is protected by copyright. All rights reserved.
基金：
This work was supported by the
National Science Foundation of China
(grants number 81971213, 81671291
and 81420108014) and National Key
R&D Program of China (grant number
2018YFC1312300)
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2021]版：
大类|2 区医学
小类|2 区临床神经病学2 区神经科学
最新[2023]版：
大类|2 区医学
小类|2 区神经科学3 区临床神经病学
第一作者：
第一作者机构：[1]Department of Neurology, West China Hospital, Sichuan University, Chengdu, China[2]Institute of Brain Science and Brain-Inspired Technology of West China Hospital, Sichuan University, Chengdu, China[3]Department of Neurology, Chengdu Shangjin Nanfu Hospital, Chengdu, China
共同第一作者：
通讯作者：
通讯机构：[1]Department of Neurology, West China Hospital, Sichuan University, Chengdu, China[2]Institute of Brain Science and Brain-Inspired Technology of West China Hospital, Sichuan University, Chengdu, China[3]Department of Neurology, Chengdu Shangjin Nanfu Hospital, Chengdu, China[*1]Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, 610041 Chengdu, Sichuan, China.
推荐引用方式(GB/T 7714)：
Gong Xue,Luo Rong,Liu Jie,et al.Efficacy and tolerability of intravenous immunoglobulin versus intravenous methylprednisolone treatment in anti- N-methyl-D-aspartate receptor encephalitis.[J].European Journal Of Neurology.2021,doi:10.1111/ene.15214.
APA：
Gong Xue,Luo Rong,Liu Jie,Guo Kundian,Li Aiqing...&Hong Zhen.(2021).Efficacy and tolerability of intravenous immunoglobulin versus intravenous methylprednisolone treatment in anti- N-methyl-D-aspartate receptor encephalitis..European Journal Of Neurology,,
MLA：
Gong Xue,et al."Efficacy and tolerability of intravenous immunoglobulin versus intravenous methylprednisolone treatment in anti- N-methyl-D-aspartate receptor encephalitis.".European Journal Of Neurology .(2021)
