The following article is part of conference coverage from the 8th Joint American Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) and European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) MSVirtual2020 event. Neurology Advisor‘s staff will be reporting breaking news associated with research conducted by leading experts in neurology. .


Patients with neuromyelitis optica spectrum disorder (NMOSD) who experience relapses use more pain medication than non-relapsing patients, according to study results presented at the 8th Joint American Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) and European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) MSVirtual2020 event, held September 11-13, 2020.

While patients with NMOSD are at risk for repeated relapses associated with increased neurological disability and pain, limited data are available on the effect of relapse on pain medication use in this population. The aim of this study was to investigate pain medication use in patients with NMOSD.

This retrospective, observational, cohort study included 47 patients (mean age at diagnosis, 46 years; 75% women) with anti-aquaporin-4 immunoglobulin G-positive (AQP4+) NMOSD from the University of Utah Health Care System.


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Optic neuritis at the initial presentation of disease was recorded in 25 (53%) patients, while transverse myelitis was documented in approximately 15(32%). 7 (15%) patients had a mixed or unknown presentation.

During the follow-up period (mean follow-up time, 4 years), relapse was documented in 14 participants. Pain medication was used in 45 of the 47 patients.

More relapsing patients with AQP4+ NMOSD than non-relapsing ones used pain medication, including opioid analgesics (79% vs 58%), non-narcotic analgesics (93% vs 43%), anti-convulsants (86% vs 46%), and musculoskeletal therapy agents (71% vs 46%).

Additionally, in patients who experienced relapse, pain medication use increased within 90 days of the relapse, compared with use prior to the relapse: opioid analgesics (27% vs 12%), non-narcotic analgesics (39% vs 12%), anti-convulsants (35% vs 27%), and musculoskeletal therapy agents (39% vs 23%). This increase suggested an association between pain and relapse activity.

“Treatment strategies that reduce relapses should be considered for all patients with NMOSD, not only to reduce traditional measures of neurological disability, but also to reduce the burden of pain and accompanying use of relapse-related pain medications,” concluded the researchers.

Visit Neurology Advisor‘s conference section for continuous coverage from the ACTRIMS/ECTRIMS MSVirtual2020 Forum.


Reference

Clardy S, Kadish R, Tanvir I. Patients with neuromyelitis optica spectrum disorder who experience relapses take more chronic pain medication. Presented at: 8th Joint American Committee for Treatment and Research in Multiple Sclerosis and European Committee for Treatment and Research in Multiple Sclerosis MSVirtual2020 event; September 11-13, 2020. Abstract P0743.