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The following is a summary of “Therapeutic inertia in the management of neuromyelitis optica spectrum disorder,” published in the February 2024 issue of Neurology by Cobo-Calvo et al.
Neurologists lack clear guidance on treating neuromyelitis optica spectrum disorder (NMOSD) with new options, potentially leading to therapeutic inertia (TI) where effective treatment is delayed.
Researchers performed a retrospective study to assess the prevalence of TI among neurologists treating NMOSD.
They conducted an online, cross-sectional study with the Spanish Society of Neurology, where neurologists completed a survey covering demographics, professional backgrounds, and behavior. TI was identified as the failure to start or escalate high-efficacy treatments despite evidence of disease activity. TI was evaluated using five simulated case scenarios of NMOSD aquaporin-4 positive (AQP4+). A multivariate logistic regression analysis determined the association between neurologists’ characteristics and TI.
The results showed 78 neurologists, with a median IQR age of 36.0 [29.0–46.0] years, 55.1% being male, and a median [IQR] experience of 5.2 [3.0–11.1] years managing demyelinating conditions. A majority (59.0%) were general neurologists, with a median (IQR) of 5.0 NMOSD patients (3.0–12.0) seen annually. TI was observed in thirty participants (38.5%). Predictors of TI included working in a low-complexity hospital and prioritizing patient tolerability/safety in treatment selection.
Investigators concluded that neurologists managing NMOSD AQP4+ freq+
66uently exhibited therapeutic inertia, highlighting interventions needed to improve treatment decisions and patient care.
Source: frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1341473/full