To evaluate the effect of relapse on quality of life in patients with neuromyelitis optica spectrum disorder (NMOSD) using phase 3 data from PREVENT.

Data are lacking on the impact of relapses on patients with NMOSD. PREVENT was a randomized, double-blind study of eculizumab in patients with aquaporin-4 immunoglobulin-G positive NMOSD, which showed a 94% reduction in the risk of adjudicated relapse versus placebo and also included survey measurements of quality of life.

Patients’ quality of life was assessed using the 5-dimension EuroQol questionnaire (EQ-5D) and the 36-item Short-Form Health Survey (SF-36), with higher values in both indicating better health status. In the current post hoc analysis, data from the eculizumab and placebo groups were pooled and the last recorded EQ-5D and SF-36 scores before an adjudicated relapse were compared (at relapse level) with post-relapse scores (recorded ≥30 days after relapse) using paired t-test.

In the absence of relapse, EQ-5D and SF-36 scores were stable over time as expected. Mean scores at pre-relapse (n = 24) and post-relapse (n = 22) were: EQ-5D index (possible range, 0–1): 0.656 and 0.595, respectively [pre–post difference, –0.067, p = 0.012]; EQ-5D visual analog score (possible range, 0–100): 60.458 and 56.500, respectively [pre–post difference, –4.227, p = 0.226]; SF-36 physical component summary score (possible range, 0–100): 38.487 and 36.431, respectively [pre–post difference, –2.602, p = 0.049]; and SF-36 mental component summary score (possible range, 0–100): 45.300 and 41.774, respectively [pre–post difference, –3.164, p = 0.041]. There were significant differences between pre- and post-relapse scores in the SF-36 domains bodily pain, physical functioning, role emotional and vitality.

This analysis suggests that relapses in patients with NMOSD are associated with a significant reduction in certain aspects of quality of life beyond the immediate relapse period.