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 language | English (US) |
|---|---|
| Pages (from-to) | e2089-e2099 |
| Journal | Neurology |
| Volume | 91 |
| Issue number | 22 |
| DOIs | |
| State | Published - Nov 27 2018 |
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ASJC Scopus subject areas
- Clinical Neurology
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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 journal › Article
}
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.
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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 -