Clinical Characteristics And Risk Factors For Pruritus In Patients With Neuromyelitis Optica Spectrum Disorders

Objective This study aimed to investigate the clinical characteristics and risk factors for pruritus in patients with neuromyelitis optica spectrum disorders (NMOSD) and evaluate its impact on patient quality of life. Methods Patients with NMOSD at the Department of Neurology of our hospital from December 2021 to August 2023 were followed up by outpatient visits or telephone interviews. The 5-D itch scale was used to evaluate pruritus intensity, the course of pruritus and pruritus-related interference in daily life during the entire disease course. We explored the factors correlated with pruritus by comparing the clinical features of patients with NMOSD with and without pruritus. Results A total of 112 patients with NMOSD were enrolled. 32(28.6%) patients had pruritus. All of these patients had myelitis. 22 (68.8%) patients had pruritus for less than 6 hours/day, 26 (81.2%) had moderate or severe pruritus intensity, 16 (50%) had complete pruritus relief, and 30 (93.8%) had never or occasionally affected daily life. Compared with patients without pruritus, patients with pruritus were more common in males ( P =0.030), younger in age ( P =0.018), with a shorter course of disease ( P =0.000), and with cervical cord lesions and longitudinally extensive transverse myelitis ( P =0.013 and 0.022, respectively). Multivariate logistic regression analysis revealed that younger age (OR=0.031, 95% CI=0.002-0.421, P =0.009), short disease duration (OR=0.810, 95% CI=0.721-0.909, P =0.000), longitudinally extensive transverse myelitis (OR=7.346, 95% CI=1.172-46.052, P =0.033), and cervical lesions (OR=8.023, 95% CI=1.501-42.852, P =0.015) were independent factors correlated with pruritus in patients with NMOSD. Conclusions Pruritus is a common clinical feature in patients with NMOSD, and it can be the initial symptom in some patients. A short disease course, younger age, cervical cord involvement and longitudinally extensive transverse myelitis are risk factors for NMOSD with pruritus. Pruritus has a minor effect on the quality of life for the majority of NMOSD patients.