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| 024 | 7 | _ | |a 10.1016/j.lanepe.2025.101562 |2 doi |
| 037 | _ | _ | |a DZNE-2025-01431 |
| 082 | _ | _ | |a 610 |
| 100 | 1 | _ | |a Brenner, Juliette |b 0 |
| 245 | _ | _ | |a Development and validation of the NEOS2 score for prediction of long-term outcomes and improvement after first-line immunotherapy in patients with anti-NMDAR encephalitis: an international cohort study |
| 260 | _ | _ | |a [Amsterdam] |c 2026 |b Elsevier |
| 336 | 7 | _ | |a article |2 DRIVER |
| 336 | 7 | _ | |a Output Types/Journal article |2 DataCite |
| 336 | 7 | _ | |a Journal Article |b journal |m journal |0 PUB:(DE-HGF)16 |s 1766392628_14399 |2 PUB:(DE-HGF) |
| 336 | 7 | _ | |a ARTICLE |2 BibTeX |
| 336 | 7 | _ | |a JOURNAL_ARTICLE |2 ORCID |
| 336 | 7 | _ | |a Journal Article |0 0 |2 EndNote |
| 500 | _ | _ | |a Funding: This study was funded by Dioraphte (charity; project 2001 0403). |
| 520 | _ | _ | |a Background: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a severe disease that primarily affects young people and can improve with adequate treatment. We aimed to refine the anti-NMDAR Encephalitis One-year functional Status (NEOS) score by developing NEOS2, an updated model using readily available data at the time of diagnosis. We assessed the predictive value of the NEOS2-score for (1) improvement following first-line treatment, (2) functional outcome at one-year follow-up, and (3) resumption of school or work within three years. Methods: In this international (France, Germany, Japan, the Netherlands and Spain) cohort study in patients with a definite anti-NMDAR encephalitis diagnosis (according to the clinical criteria plus antibody testing in CSF), we performed logistic regression analyses to develop and validate multivariable models to predict -based upon variables available at diagnosis- short (ΔmRS two weeks after first-line treatment), middle (modified Rankin Scale [mRS] at one year), and long-term (return to school or work within three years) outcomes. We included clinical variables and biomarkers available at diagnosis. Findings: We included 702 patients (mean age 23 years, 95%-CI 2–69; 79% female, 21% male) diagnosed between the discovery of the disease in 2007 and 2022. Most patients (96%; 672/702) had received first-line immunotherapy, and 38% (233/615) showed improvement within two weeks. One year after diagnosis, 80% (517/644) had a favourable functional outcome (mRS≤2). At three years, 73% (203/278) had resumed work/school. In multivariable analysis, higher age (odds ratio [OR] 0·35, 95%-CI 0·29–0·43, p < 0·0001), treatment delay (OR 0·49, 95%-CI 0·41–0·58, p < 0·0001), movement disorders (OR 0·32, 95%-CI 0·24–0·41, p < 0·0001), ICU-requirement (OR 0·34, 95%-CI 0·26–0·44, p < 0·0001) and increased CSF leucocyte count (OR 0·65, 95%-CI 0·60–0·71, p < 0·0001) independently predicted poorer outcomes (NEOS2, accuracy AUC 80%, 95%-CI 75–86%). The same variables, excluding age, were relevant in predicting improvement following first-line immunotherapy (NEOS2-T AUC 81–84%, 95%-CI 77–86%). Return-to-work or -school served as a useful measure of longer-term outcomes, predicted with equal accuracy as one-year functional outcome (NEOS2-W AUC 80%, 95%-CI 75–85%). The NEOS2-score, applied as an ordinal measure, enabled nuanced predictions of outcome probabilities across the score spectrum, ranging from a high (80%; n = 20/25) likelihood of improving after first-line immunotherapy and achieving a good outcome (100%; n = 32/32) to a high risk of first-line treatment failure (97%; n = 77/79) and no return to school/work (94%; n = 15/16). Interpretation: The NEOS2-score, readily available at diagnosis and easy to apply, can identify patients with either a favourable or poor prognosis, and those who may benefit from early intensified treatment. The value of the NEOS2-score for guiding treatment decisions and as a stratification tool in studies on optimal treatment regimens, should be confirmed in further prospective studies. |
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| 588 | _ | _ | |a Dataset connected to CrossRef, Journals: pub.dzne.de |
| 700 | 1 | _ | |a Bastiaansen, Anna E. M. |b 1 |
| 700 | 1 | _ | |a Guasp, Mar |0 0000-0002-0110-5213 |b 2 |
| 700 | 1 | _ | |a Muñiz-Castrillo, Sergio |b 3 |
| 700 | 1 | _ | |a Iizuka, Takahiro |0 0000-0002-7234-0720 |b 4 |
| 700 | 1 | _ | |a de Bruijn, Marienke A. A. M. |b 5 |
| 700 | 1 | _ | |a Muñoz-Lopetegi, Amaia |b 6 |
| 700 | 1 | _ | |a Martínez-Hernández, Eugenia |b 7 |
| 700 | 1 | _ | |a Picard, Géraldine |b 8 |
| 700 | 1 | _ | |a Vogrig, Alberto |0 0000-0002-3652-7061 |b 9 |
| 700 | 1 | _ | |a Millot, Mathilde |b 10 |
| 700 | 1 | _ | |a Finke, Carsten |b 11 |
| 700 | 1 | _ | |a Geis, Christian |b 12 |
| 700 | 1 | _ | |a Lewerenz, Jan |b 13 |
| 700 | 1 | _ | |a Melzer, Nico |0 0000-0002-2420-701X |b 14 |
| 700 | 1 | _ | |a Prüss, Harald |0 P:(DE-2719)2810931 |b 15 |
| 700 | 1 | _ | |a Räuber, Saskia |0 0000-0001-8901-5572 |b 16 |
| 700 | 1 | _ | |a Ringelstein, Marius |b 17 |
| 700 | 1 | _ | |a Rostàsy, Kevin |b 18 |
| 700 | 1 | _ | |a Sühs, Kurt-Wolfram |b 19 |
| 700 | 1 | _ | |a Thaler, Franziska S. |b 20 |
| 700 | 1 | _ | |a Wandinger, Klaus-Peter |b 21 |
| 700 | 1 | _ | |a Wurdack, Katharina |b 22 |
| 700 | 1 | _ | |a Crijnen, Yvette S. |b 23 |
| 700 | 1 | _ | |a Kerstens, Jeroen |b 24 |
| 700 | 1 | _ | |a van Steenhoven, Robin W. |b 25 |
| 700 | 1 | _ | |a Veenbergen, Sharon |b 26 |
| 700 | 1 | _ | |a Schreurs, Marco W. J. |b 27 |
| 700 | 1 | _ | |a van den Berg, Robert |0 0000-0003-4806-3599 |b 28 |
| 700 | 1 | _ | |a Volovici, Victor |b 29 |
| 700 | 1 | _ | |a Neuteboom, Rinze F. |b 30 |
| 700 | 1 | _ | |a de Vries, Juna M. |b 31 |
| 700 | 1 | _ | |a Sillevis Smitt, Peter A. E. |b 32 |
| 700 | 1 | _ | |a Nagtzaam, Mariska M. P. |b 33 |
| 700 | 1 | _ | |a Franken, Suzanne C. |b 34 |
| 700 | 1 | _ | |a Ratuszny, Dominica |b 35 |
| 700 | 1 | _ | |a Menge, Til |b 36 |
| 700 | 1 | _ | |a Bertolini, Annikki |b 37 |
| 700 | 1 | _ | |a Bien, Christian |b 38 |
| 700 | 1 | _ | |a Berger, Robert |b 39 |
| 700 | 1 | _ | |a Tauber, Simone |b 40 |
| 700 | 1 | _ | |a Angstwurm, Klemens |b 41 |
| 700 | 1 | _ | |a Seifert-Held, Thomas |b 42 |
| 700 | 1 | _ | |a Kraft, Andrea |b 43 |
| 700 | 1 | _ | |a Klausewitz, Jaqueline |b 44 |
| 700 | 1 | _ | |a Ayzenberg, Ilya |b 45 |
| 700 | 1 | _ | |a Eisenhut, Katharina |b 46 |
| 700 | 1 | _ | |a Roessling, Rosa |0 P:(DE-2719)9001490 |b 47 |u dzne |
| 700 | 1 | _ | |a Heiden, Martha |b 48 |
| 700 | 1 | _ | |a Kümpfel, Tania |b 49 |
| 700 | 1 | _ | |a Dalmau, Josep |b 50 |
| 700 | 1 | _ | |a Leypoldt, Frank |b 51 |
| 700 | 1 | _ | |a Honnorat, Jérôme |0 0000-0002-4721-5952 |b 52 |
| 700 | 1 | _ | |a Titulaer, Maarten J. |0 0000-0002-1033-3840 |b 53 |
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