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
N1 - Funding Information:
This work was supported by the Bio & Medical Technology Development Program (M3A9B6069339) through the Ministry of Science & ICT, Republic of Korea, and by the Deutsche Forschungsgemeinschaft (DFG Exc 257 to F.P.).
Funding Information:
S. Kim and M. Mealy report no disclosures relevant to the manuscript. M. Levy currently receives research support from the NIH, Maryland Technology Development Corporation, Sanofi, Genzyme, Alexion, Alnylam, Shire, Acorda, and Apo-Pharma. He also received personal compensation for consultation with Alexion, Acorda, and Genzyme, and he serves on the scientific advisory boards for Alexion, Acorda, and Quest Diagnostics. F. Schmidt reports no disclosures relevant to the manuscript. K. Ruprecht has received research grants from the German Ministry of Education and Research (BMBF/ KKNMS, Competence Network Multiple Sclerosis), Novartis, Merck Serono, and the Charité Research Fund; honoraria for consultancy or speaking and travel reimbursement from Novartis, Bayer Healthcare, Biogen Idec, Merck Serono, Sanofi-Aventis/Genzyme, Teva Pharmaceuticals, and the Guthy-Jackson Charitable Foundation. F. Paul reports no disclosures relevant to the manuscript. M. Ringelstein received consulting and speaker honoraria as well as travel reimbursements from Bayer, Biogen, Genzyme, Teva, Merz, Ipsen, and Novartis. O. Aktas, H. Hartung, N. Asgari, J. Tsz-Ching, S. Siritho, N. Prayoonwiwat, H. Shin, J. Hyun, and M. Han report no disclosures relevant to the manuscript. M. Leite receives support from NHS National Specialized Commissioning Group for Neuromyelitis Optica UK and NIHR Oxford Biomedical Research Centre; received travel funding and speaker honoraria from Biogen Idec; and received a travel grant from Novartis. J. Palace reports no disclosures relevant to the manuscript. H. Kim has lectured and consulted for, and received honoraria from, Bayer Schering Pharma, Biogen, Celltrion, Eisai, Genzyme, HanAll BioPharma, MedImmune, Merck Serono, Novartis, Teva-Handok, and UCB; received a grant from the Ministry of Science & ICT; accepted research funding from Genzyme, Kael-GemVax, Merck Serono, Teva-Handok, and UCB; serves on a steering committee for MedImmune; is a coeditor for the Multiple Sclerosis Journal—Experimental, Translational and Clinical and an associated editor for the Journal of Clinical Neurology. Go to Neurology.org/N for full disclosures.
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.
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U2 - 10.1212/WNL.0000000000006574
DO - 10.1212/WNL.0000000000006574
M3 - Article
C2 - 30366977
AN - SCOPUS:85057148184
VL - 91
SP - E2089-E2099
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 22
ER -