- •Azathioprine was inferior to rituximab for neuromyelitis optica spectrum disorder (NMOSD).
- •Current efficacy data for azathioprine compared to other studied drugs were very limited.
- •Azathioprine was linked to frequent adverse events which may lead to intolerance.
- •At present, azathioprine may be offered as second-line treatment option for patients with NMOSD.
Abbreviations:ADE (adverse drug events), AQP4-IgG (aquaporin-4-immunoglobulin G), ARR (annualized relapse rate), AZA (azathioprine), CENTRAL (Cochrane Central Register of Controlled Trials), CI (confidence interval), CYP (cyclophosphamide), EDSS (expanded disability status scale), EFNS (European Federation of Neurological Societies), EMBASE (Excerpta Medica dataBASE), F:M (female-to-male ratio), HERDIN (Health Research and Development Information Network), HRR (hazard risk for relapse), INFβ (interferon-β), IPND (International Panel for NMO Diagnosis), LILACS (Literatura Latino-Americana e do Caribe em Ciências da Saúde), MeSH (Medical Subject Headings), MMF (mycophenolate mofetil), MOOSE (Meta-analysis Of Observational Studies in Epidemiology), NMO (neuromyelitis optica), NMOSD (neuromyelitis optica spectrum disorder), NOS (Newcastle–Ottawa Scale), PCS (prospective cohort studies), PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses), RCS (retrospective cohort studies), RCT (randomized controlled trial), RFR (relapse-free rate), RR (risk ratio), RTX (rituximab), SD (standard deviation), TPMT (thiopurine methyltransferase)
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