Racial differences in neuromyelitis optica spectrum disorder

Su Hyun Kim, Maureen A. Mealy, Michael Levy, Felix Schmidt, Klemens Ruprecht, Friedemann Paul, Marius Ringelstein, Orhan Aktas, Hans Peter Hartung, Nasrin Asgari, Jessica Li Tsz-Ching, Sasitorn Siritho, Naraporn Prayoonwiwat, Hyun June Shin, Jae Won Hyun, Mira Han, Maria Isabel Leite, Jacqueline Palace, Ho Jin Kim

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: We aimed to evaluate racial differences in the clinical features of neuromyelitis optica spectrum disorder. METHODS: This retrospective review included 603 patients (304 Asian, 207 Caucasian, and 92 Afro-American/Afro-European), who were seropositive for anti-aquaporin-4 antibody, from 6 centers in Denmark, Germany, South Korea, United Kingdom, United States, and Thailand. RESULTS: Median disease duration at last follow-up was 8 years (range 0.3-38.4 years). Asian and Afro-American/Afro-European patients had a younger onset age than Caucasian patients (mean 36, 33, and 44 years, respectively; p < 0.001). During the disease course, Caucasian patients (23%) had a lower incidence of brain/brainstem involvement than Asian (42%) and Afro-American/Afro-European patients (38%) (p < 0.001). Severe attacks (visual acuity ≤0.1 in at least one eye or Expanded Disability Status Scale score ≥6.0 at nadir) at onset occurred more frequently in Afro-American/Afro-European (58%) than in Asian (46%) and Caucasian (38%) patients (p = 0.005). In the multivariable analysis, older age at onset, higher number of attacks before and after immunosuppressive treatment, but not race, were independent predictors of severe motor disabilities at last follow-up. CONCLUSION: A review of a large international cohort revealed that race affected the clinical phenotype, age at onset, and severity of attacks, but the overall outcome was most dependent on early and effective immunosuppressive treatment.

Original languageEnglish (US)
Pages (from-to)e2089-e2099
JournalNeurology
Volume91
Issue number22
DOIs
StatePublished - Nov 27 2018

Fingerprint

Neuromyelitis Optica
Age of Onset
Immunosuppressive Agents
Aquaporin 4
Republic of Korea
Asian Americans
Thailand
Denmark
Visual Acuity
Brain Stem
Germany
Phenotype
Antibodies
Incidence
Brain
Therapeutics

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Kim, S. H., Mealy, M. A., Levy, M., Schmidt, F., Ruprecht, K., Paul, F., ... Kim, H. J. (2018). Racial differences in neuromyelitis optica spectrum disorder. Neurology, 91(22), e2089-e2099. https://doi.org/10.1212/WNL.0000000000006574

Racial differences in neuromyelitis optica spectrum disorder. / Kim, Su Hyun; Mealy, Maureen A.; Levy, Michael; Schmidt, Felix; Ruprecht, Klemens; Paul, Friedemann; Ringelstein, Marius; Aktas, Orhan; Hartung, Hans Peter; Asgari, Nasrin; Tsz-Ching, Jessica Li; Siritho, Sasitorn; Prayoonwiwat, Naraporn; Shin, Hyun June; Hyun, Jae Won; Han, Mira; Leite, Maria Isabel; Palace, Jacqueline; Kim, Ho Jin.

In: Neurology, Vol. 91, No. 22, 27.11.2018, p. e2089-e2099.

Research output: Contribution to journalArticle

Kim, SH, Mealy, MA, Levy, M, Schmidt, F, Ruprecht, K, Paul, F, Ringelstein, M, Aktas, O, Hartung, HP, Asgari, N, Tsz-Ching, JL, Siritho, S, Prayoonwiwat, N, Shin, HJ, Hyun, JW, Han, M, Leite, MI, Palace, J & Kim, HJ 2018, 'Racial differences in neuromyelitis optica spectrum disorder', Neurology, vol. 91, no. 22, pp. e2089-e2099. https://doi.org/10.1212/WNL.0000000000006574
Kim SH, Mealy MA, Levy M, Schmidt F, Ruprecht K, Paul F et al. Racial differences in neuromyelitis optica spectrum disorder. Neurology. 2018 Nov 27;91(22):e2089-e2099. https://doi.org/10.1212/WNL.0000000000006574
Kim, Su Hyun ; Mealy, Maureen A. ; Levy, Michael ; Schmidt, Felix ; Ruprecht, Klemens ; Paul, Friedemann ; Ringelstein, Marius ; Aktas, Orhan ; Hartung, Hans Peter ; Asgari, Nasrin ; Tsz-Ching, Jessica Li ; Siritho, Sasitorn ; Prayoonwiwat, Naraporn ; Shin, Hyun June ; Hyun, Jae Won ; Han, Mira ; Leite, Maria Isabel ; Palace, Jacqueline ; Kim, Ho Jin. / Racial differences in neuromyelitis optica spectrum disorder. In: Neurology. 2018 ; Vol. 91, No. 22. pp. e2089-e2099.
@article{cf8b99944f5e43d4b67cffa9036608f5,
title = "Racial differences in neuromyelitis optica spectrum disorder",
abstract = "OBJECTIVE: We aimed to evaluate racial differences in the clinical features of neuromyelitis optica spectrum disorder. METHODS: This retrospective review included 603 patients (304 Asian, 207 Caucasian, and 92 Afro-American/Afro-European), who were seropositive for anti-aquaporin-4 antibody, from 6 centers in Denmark, Germany, South Korea, United Kingdom, United States, and Thailand. RESULTS: Median disease duration at last follow-up was 8 years (range 0.3-38.4 years). Asian and Afro-American/Afro-European patients had a younger onset age than Caucasian patients (mean 36, 33, and 44 years, respectively; p < 0.001). During the disease course, Caucasian patients (23{\%}) had a lower incidence of brain/brainstem involvement than Asian (42{\%}) and Afro-American/Afro-European patients (38{\%}) (p < 0.001). Severe attacks (visual acuity ≤0.1 in at least one eye or Expanded Disability Status Scale score ≥6.0 at nadir) at onset occurred more frequently in Afro-American/Afro-European (58{\%}) than in Asian (46{\%}) and Caucasian (38{\%}) patients (p = 0.005). In the multivariable analysis, older age at onset, higher number of attacks before and after immunosuppressive treatment, but not race, were independent predictors of severe motor disabilities at last follow-up. CONCLUSION: A review of a large international cohort revealed that race affected the clinical phenotype, age at onset, and severity of attacks, but the overall outcome was most dependent on early and effective immunosuppressive treatment.",
author = "Kim, {Su Hyun} and Mealy, {Maureen A.} and Michael Levy and Felix Schmidt and Klemens Ruprecht and Friedemann Paul and Marius Ringelstein and Orhan Aktas and Hartung, {Hans Peter} and Nasrin Asgari and Tsz-Ching, {Jessica Li} and Sasitorn Siritho and Naraporn Prayoonwiwat and Shin, {Hyun June} and Hyun, {Jae Won} and Mira Han and Leite, {Maria Isabel} and Jacqueline Palace and Kim, {Ho Jin}",
year = "2018",
month = "11",
day = "27",
doi = "10.1212/WNL.0000000000006574",
language = "English (US)",
volume = "91",
pages = "e2089--e2099",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "22",

}

TY - JOUR

T1 - Racial differences in neuromyelitis optica spectrum disorder

AU - Kim, Su Hyun

AU - Mealy, Maureen A.

AU - Levy, Michael

AU - Schmidt, Felix

AU - Ruprecht, Klemens

AU - Paul, Friedemann

AU - Ringelstein, Marius

AU - Aktas, Orhan

AU - Hartung, Hans Peter

AU - Asgari, Nasrin

AU - Tsz-Ching, Jessica Li

AU - Siritho, Sasitorn

AU - Prayoonwiwat, Naraporn

AU - Shin, Hyun June

AU - Hyun, Jae Won

AU - Han, Mira

AU - Leite, Maria Isabel

AU - Palace, Jacqueline

AU - Kim, Ho Jin

PY - 2018/11/27

Y1 - 2018/11/27

N2 - OBJECTIVE: We aimed to evaluate racial differences in the clinical features of neuromyelitis optica spectrum disorder. METHODS: This retrospective review included 603 patients (304 Asian, 207 Caucasian, and 92 Afro-American/Afro-European), who were seropositive for anti-aquaporin-4 antibody, from 6 centers in Denmark, Germany, South Korea, United Kingdom, United States, and Thailand. RESULTS: Median disease duration at last follow-up was 8 years (range 0.3-38.4 years). Asian and Afro-American/Afro-European patients had a younger onset age than Caucasian patients (mean 36, 33, and 44 years, respectively; p < 0.001). During the disease course, Caucasian patients (23%) had a lower incidence of brain/brainstem involvement than Asian (42%) and Afro-American/Afro-European patients (38%) (p < 0.001). Severe attacks (visual acuity ≤0.1 in at least one eye or Expanded Disability Status Scale score ≥6.0 at nadir) at onset occurred more frequently in Afro-American/Afro-European (58%) than in Asian (46%) and Caucasian (38%) patients (p = 0.005). In the multivariable analysis, older age at onset, higher number of attacks before and after immunosuppressive treatment, but not race, were independent predictors of severe motor disabilities at last follow-up. CONCLUSION: A review of a large international cohort revealed that race affected the clinical phenotype, age at onset, and severity of attacks, but the overall outcome was most dependent on early and effective immunosuppressive treatment.

AB - OBJECTIVE: We aimed to evaluate racial differences in the clinical features of neuromyelitis optica spectrum disorder. METHODS: This retrospective review included 603 patients (304 Asian, 207 Caucasian, and 92 Afro-American/Afro-European), who were seropositive for anti-aquaporin-4 antibody, from 6 centers in Denmark, Germany, South Korea, United Kingdom, United States, and Thailand. RESULTS: Median disease duration at last follow-up was 8 years (range 0.3-38.4 years). Asian and Afro-American/Afro-European patients had a younger onset age than Caucasian patients (mean 36, 33, and 44 years, respectively; p < 0.001). During the disease course, Caucasian patients (23%) had a lower incidence of brain/brainstem involvement than Asian (42%) and Afro-American/Afro-European patients (38%) (p < 0.001). Severe attacks (visual acuity ≤0.1 in at least one eye or Expanded Disability Status Scale score ≥6.0 at nadir) at onset occurred more frequently in Afro-American/Afro-European (58%) than in Asian (46%) and Caucasian (38%) patients (p = 0.005). In the multivariable analysis, older age at onset, higher number of attacks before and after immunosuppressive treatment, but not race, were independent predictors of severe motor disabilities at last follow-up. CONCLUSION: A review of a large international cohort revealed that race affected the clinical phenotype, age at onset, and severity of attacks, but the overall outcome was most dependent on early and effective immunosuppressive treatment.

UR - http://www.scopus.com/inward/record.url?scp=85057148184&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85057148184&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000006574

DO - 10.1212/WNL.0000000000006574

M3 - Article

VL - 91

SP - e2089-e2099

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 22

ER -