Use and Safety of Immunotherapeutic Management of N-Methyl- d -Aspartate Receptor Antibody Encephalitis

作者：Margherita Nosadini, Michael Eyre, Erika Molteni, Terrence Gerard Sundram Thomas, Sarosh R. Irani, Josep O. Dalmau, Russell Clive Dale, Ming Jin Lim, International NMDAR Antibody Encephalitis Consensus Group, Banu Anlar, Thaís Armangué, Susanne M. Benseler, Tania Cellucci, Kumaran Deiva, William Brian Gallentine, Grace Yoonheekim Gombolay, Mark Gorman, Yael Hacohen, Yuwu Jiang, Byung Chan Lim, Eyal Muscal, Alvin Ndondo, Rinze Frederik Neuteboom, Kevin M. Rostasy, Hiroshi Sakuma, Stefano Sartori, Suvasini Sharma, Silvia Noemi Tenembaum, Heather Ann Van Mater, Elizabeth Wells, Ronny Wickström, Anusha K. Yeshokumar · 发表于：JAMA Neurology · 年份：2021 · DOI：10.1001/jamaneurol.2021.3188 · 被引用次数：226 · 研究领域：Autoimmune Neurological Disorders and Treatments、Multiple Sclerosis Research Studies、Peripheral Neuropathies and Disorders

Importance: Overall, immunotherapy has been shown to improve outcomes and reduce relapses in individuals with N-methyl-d-aspartate receptor (NMDAR) antibody encephalitis (NMDARE); however, the superiority of specific treatments and combinations remains unclear. Objective: To map the use and safety of immunotherapies in individuals with NMDARE, identify early predictors of poor functional outcome and relapse, evaluate changes in immunotherapy use and disease outcome over the 14 years since first reports of NMDARE, and assess the Anti-NMDAR Encephalitis One-Year Functional Status (NEOS) score. Data Sources: Systematic search in PubMed from inception to January 1, 2019. Study Selection: Published articles including patients with NMDARE with positive NMDAR antibodies and available individual immunotherapy data. Data Extraction and Synthesis: Individual patient data on immunotherapies, clinical characteristics at presentation, disease course, and final functional outcome (modified Rankin Scale [mRS] score) were entered into multivariable logistic regression models. Main Outcomes and Measures: The planned study outcomes were functional outcome at 12 months from disease onset (good, mRS score of 0 to 2; poor, mRS score greater than 2) and monophasic course (absence of relapse at 24 months or later from onset). Results: Data from 1550 patients from 652 articles were evaluated. Of these, 1105 of 1508 (73.3%) were female and 707 of 1526 (46.3%) were 18 years or younger at disease onset...