In a groundbreaking study on 171 NMOSD patients, researchers found that a decrease in Aquaporin-4 antibody titers led to a significant reduction in relapse rates. Specifically, 25.7% of patients became AQP4-IgG seronegative, resulting in a remarkable decrease in annualized relapse rate. The decline in AQP4-IgG levels was identified as a protective factor against relapse, highlighting the potential of cell-based assays to predict disease outcomes. Moreover, patients treated solely with monoclonal antibodies showed a higher likelihood of seroreversion compared to those on non-specific immunosuppressants or those transitioning from immunosuppressants to monoclonal antibodies. Interestingly, factors such as male sex, baseline AQP4-IgG titer, and continuous monoclonal antibody treatment were independently associated with seroreversion, shedding light on personalized treatment strategies for NMOSD. This study underscores the importance of monitoring Aquaporin-4 antibody levels and tailoring treatment approaches based on cell-based assays to improve outcomes in patients with neuromyelitis optica.
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