Systemic Connective Tissue Disease and Neuromyelitis Optica Spectrum Disorder Coexistence: A Systematic Review and Meta-Analysis
Background: Several results support the hypothesis that a group of pathologies falling within the Neuromyelitis Optica Spectrum Disorders (NMOSD) diagnostic criteria may coexist with Connective Tissue Diseases (CTD) in patients with a high susceptibility to autoimmune conditions. However, the relati...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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IMR Press
2024-02-01
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| Series: | Journal of Integrative Neuroscience |
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| Online Access: | https://www.imrpress.com/journal/JIN/23/2/10.31083/j.jin2302035 |
| _version_ | 1797291528363704320 |
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| author | Jessica Elisabetta Esposito Giovanni Annoni Milena D’Amato Alessandra Graziosi Francesca Troilo Annalisa Di Risio Gilda Angelini Caterina Castiglione Pierluigi Tocco Paola Volpe Giancarlo Di Iorio Giustino Parruti Ennio Polilli |
| author_facet | Jessica Elisabetta Esposito Giovanni Annoni Milena D’Amato Alessandra Graziosi Francesca Troilo Annalisa Di Risio Gilda Angelini Caterina Castiglione Pierluigi Tocco Paola Volpe Giancarlo Di Iorio Giustino Parruti Ennio Polilli |
| author_sort | Jessica Elisabetta Esposito |
| collection | DOAJ |
| description | Background: Several results support the hypothesis that a group of pathologies falling within the Neuromyelitis Optica Spectrum Disorders (NMOSD) diagnostic criteria may coexist with Connective Tissue Diseases (CTD) in patients with a high susceptibility to autoimmune conditions. However, the relationship between NMOSD and rheumatologic diseases deserves further investigations to clarify all clinical aspects of this coexistence. We designed a systematic review and a proportional meta-analysis to estimate the association between CTD and MNOSD, with the aim of helping to plan the best strategy to achieve the most significant public health benefit for these conditions. Methods: We conducted a systematic review of the literature published until February 2023, searching in four databases: PubMed, Web of Science, EmBase, and OVID. Then, we conducted a random-effects proportional meta-analysis and assessed the risk of bias of the included studies using the Joanna Briggs Institute checklist. Results: The literature search yielded an overall result of 3176 publications (272 from PubMed, 880 from Web of Science, 634 from EmBase and 1390 from OVID). Of these, 29 were included in this systematic review. Analyzing studies that recruited unselected patients with Systemic Lupus Erythematosus (SLE) and Sjogren Syndrome (SjS), the pooled percentages of NMOSD overlapping were 0.6% (95% Confidence Interval [95% CI]: 0.1%–1.4%,) and 6.5% (95% CI: 4.7–8.6), respectively. Studies enrolling rheumatologic patients with nervous system symptoms involvement reported higher percentage of NMOSD (i.e., among SjS patients, a pooled percentage of 26.5%, 95% CI: 5.5–54.6%, was found). Similarly, recruiting patients with NMOSD, we found pooled percentages of SjS or SLE respectively of 7.0% and 3.5%. Conclusions: Our research found that the coexistence of these two disorders was more frequent in female rheumatologic patients with a SjS diagnosis with neurological manifestations and in neurologic patients for whom a SjS diagnosis was suspected. Similarly, NMOSD are less frequently found in SLE and very rarely incident in Mixed Connective Tissue Disease (MCTD) patients. These considerations should be taken into account in clinical experience of rheumatologists and neurologists, since early diagnosis of both conditions may influence the timing of immunosuppressive therapy and the prevention of systemic disabilities. |
| first_indexed | 2024-03-07T19:38:06Z |
| format | Article |
| id | doaj.art-e2d9dff0f9794b60b6c5baadae983948 |
| institution | Directory Open Access Journal |
| issn | 0219-6352 |
| language | English |
| last_indexed | 2024-03-07T19:38:06Z |
| publishDate | 2024-02-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Journal of Integrative Neuroscience |
| spelling | doaj.art-e2d9dff0f9794b60b6c5baadae9839482024-02-29T08:00:15ZengIMR PressJournal of Integrative Neuroscience0219-63522024-02-012323510.31083/j.jin2302035S0219-6352(23)00670-8Systemic Connective Tissue Disease and Neuromyelitis Optica Spectrum Disorder Coexistence: A Systematic Review and Meta-AnalysisJessica Elisabetta Esposito0Giovanni Annoni1Milena D’Amato2Alessandra Graziosi3Francesca Troilo4Annalisa Di Risio5Gilda Angelini6Caterina Castiglione7Pierluigi Tocco8Paola Volpe9Giancarlo Di Iorio10Giustino Parruti11Ennio Polilli12Clinical Pathology Unit, Pescara General Hospital, 65124 Pescara, ItalyDepartment of Innovative Technology in Medicine and Odontoiatrics, University “G. d’Annunzio”, 66013 Chieti, ItalyClinical Pathology Unit, Pescara General Hospital, 65124 Pescara, ItalyDepartment of Innovative Technology in Medicine and Odontoiatrics, University “G. d’Annunzio”, 66013 Chieti, ItalyDepartment of Innovative Technology in Medicine and Odontoiatrics, University “G. d’Annunzio”, 66013 Chieti, ItalyClinical Pathology Unit, Pescara General Hospital, 65124 Pescara, ItalyClinical Pathology Unit, Pescara General Hospital, 65124 Pescara, ItalyClinical Pathology Unit, Pescara General Hospital, 65124 Pescara, ItalyNeurology and Stroke Unit, Pescara General Hospital, 65124 Pescara, ItalyReumathology Unit, Pescara General Hospital, 65124 Pescara, ItalyClinical Pathology Unit, Pescara General Hospital, 65124 Pescara, ItalyDepartment of Medicine, Pescara General Hospital, 65124 Pescara, ItalyClinical Pathology Unit, Pescara General Hospital, 65124 Pescara, ItalyBackground: Several results support the hypothesis that a group of pathologies falling within the Neuromyelitis Optica Spectrum Disorders (NMOSD) diagnostic criteria may coexist with Connective Tissue Diseases (CTD) in patients with a high susceptibility to autoimmune conditions. However, the relationship between NMOSD and rheumatologic diseases deserves further investigations to clarify all clinical aspects of this coexistence. We designed a systematic review and a proportional meta-analysis to estimate the association between CTD and MNOSD, with the aim of helping to plan the best strategy to achieve the most significant public health benefit for these conditions. Methods: We conducted a systematic review of the literature published until February 2023, searching in four databases: PubMed, Web of Science, EmBase, and OVID. Then, we conducted a random-effects proportional meta-analysis and assessed the risk of bias of the included studies using the Joanna Briggs Institute checklist. Results: The literature search yielded an overall result of 3176 publications (272 from PubMed, 880 from Web of Science, 634 from EmBase and 1390 from OVID). Of these, 29 were included in this systematic review. Analyzing studies that recruited unselected patients with Systemic Lupus Erythematosus (SLE) and Sjogren Syndrome (SjS), the pooled percentages of NMOSD overlapping were 0.6% (95% Confidence Interval [95% CI]: 0.1%–1.4%,) and 6.5% (95% CI: 4.7–8.6), respectively. Studies enrolling rheumatologic patients with nervous system symptoms involvement reported higher percentage of NMOSD (i.e., among SjS patients, a pooled percentage of 26.5%, 95% CI: 5.5–54.6%, was found). Similarly, recruiting patients with NMOSD, we found pooled percentages of SjS or SLE respectively of 7.0% and 3.5%. Conclusions: Our research found that the coexistence of these two disorders was more frequent in female rheumatologic patients with a SjS diagnosis with neurological manifestations and in neurologic patients for whom a SjS diagnosis was suspected. Similarly, NMOSD are less frequently found in SLE and very rarely incident in Mixed Connective Tissue Disease (MCTD) patients. These considerations should be taken into account in clinical experience of rheumatologists and neurologists, since early diagnosis of both conditions may influence the timing of immunosuppressive therapy and the prevention of systemic disabilities.https://www.imrpress.com/journal/JIN/23/2/10.31083/j.jin2302035connective tissue diseasecoexistence of autoimmune diseasesautoimmunityneuromyelitis optica spectrum disorders |
| spellingShingle | Jessica Elisabetta Esposito Giovanni Annoni Milena D’Amato Alessandra Graziosi Francesca Troilo Annalisa Di Risio Gilda Angelini Caterina Castiglione Pierluigi Tocco Paola Volpe Giancarlo Di Iorio Giustino Parruti Ennio Polilli Systemic Connective Tissue Disease and Neuromyelitis Optica Spectrum Disorder Coexistence: A Systematic Review and Meta-Analysis Journal of Integrative Neuroscience connective tissue disease coexistence of autoimmune diseases autoimmunity neuromyelitis optica spectrum disorders |
| title | Systemic Connective Tissue Disease and Neuromyelitis Optica Spectrum Disorder Coexistence: A Systematic Review and Meta-Analysis |
| title_full | Systemic Connective Tissue Disease and Neuromyelitis Optica Spectrum Disorder Coexistence: A Systematic Review and Meta-Analysis |
| title_fullStr | Systemic Connective Tissue Disease and Neuromyelitis Optica Spectrum Disorder Coexistence: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Systemic Connective Tissue Disease and Neuromyelitis Optica Spectrum Disorder Coexistence: A Systematic Review and Meta-Analysis |
| title_short | Systemic Connective Tissue Disease and Neuromyelitis Optica Spectrum Disorder Coexistence: A Systematic Review and Meta-Analysis |
| title_sort | systemic connective tissue disease and neuromyelitis optica spectrum disorder coexistence a systematic review and meta analysis |
| topic | connective tissue disease coexistence of autoimmune diseases autoimmunity neuromyelitis optica spectrum disorders |
| url | https://www.imrpress.com/journal/JIN/23/2/10.31083/j.jin2302035 |
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