Photo Credit: Selvanegra
With the NEOS2 model, an internationally validated, easy-to-use tool has arrived to predict which patients with anti-NMDAR encephalitis will improve on first-line therapy. Importantly, this model is already applicable at diagnosis.
“With the NEOS score, we can adequately predict the outcome of patients with anti-NMDAR encephalitis one month after treatment,” said Dr. Juliette Brenner, PhD, from the Erasmus Medical Centre Rotterdam, in the Netherlands. It would be better if physicians could predict the outcome of first-line therapy for these patients at diagnosis. “Then we would know which patients would benefit from first-line therapy and which patients need to receive more aggressive therapies,” explained Dr. Brenner. The research team developed the NEOS2 score in order to overcome these issues.
The NEOS2 tool was developed in a cohort of 712 patients with anti-NMDAR encephalitis from five countries. The original NEOS model included a ‘need for ICU admission’, MRI abnormalities, CSF leukocyte count greater than 20 cells/µL, a treatment delay greater than 4 weeks, and a lack of response to first-line therapy as independent variables. By adding age and the interaction effect between treatment delay and the number of leukocytes to the model, and by omitting the effect of first-line therapy, the NEOS2 score yielded the same accuracy for predicting the 1 year outcome as the original NEOS score. Furthermore, the new model was successful at predicting response to first-line therapy and at predicting which patients would return to school or work after 3 years. Because of the omission of first-line therapy effect as a variable, the NEOS2 score can already be used at diagnosis.
Medical writing support was provided by Robert van den Heuvel.
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