Author Of 1 Presentation
P0717 - Frequency of comorbidities in Neuromyelitis Optica spectrum disorder (ID 459)
Abstract
Background
Comorbidity may influence clinical aspects of neuromyelitis optica spectrum disorder (NMOSD). However, there is little knowledge regarding the interaction between comorbidities and NMOSD.
Objectives
We conducted this study to estimate the prevalence of comorbidities in NMOSD patients and assessed their association with disease outcomes.
Methods
This retrospective study assessed records of patients ( interview and medical report abstraction) from 2008 to 2019, categorizing comorbidities into three groups: somatic, psychiatric and autoimmune. We also evaluated the smoking status and BMI as health factors. Severity of disease was evaluated by the Expanded Disability Status Scale (EDSS), progression index (PI) and annualized relapse rate. The frequency of comorbidities was compared between anti-aquaporin 4 antibody (AQP4-IgG) seropositive and matched seronegative patients. Unadjusted and adjusted regression analysis were performed to assess the association between disease outcomes with comorbidities. To compare the frequency of comorbidities between AQP4-IgG seropostive and seronegative patients, we performed propensity score matching (PSM)
Results
A total of 115 NMOSD patients were enrolled. Fifty-five (47.8%) patients reported at least one comorbidity. In total, 69 comorbidities were found, of which 44 occurred prior to NMOSD onset: 43 somatic, 22 psychiatric and four autoimmune entities. The most common comorbidities were migraine 11/115 (9.6%), anxiety disorders 11/115 (9.6%), major depression disorder n=9 (7.8%), iron deficiency anemia 9/115 (7.8%) and non-autoimmune hypothyroidism 8/115 (7.0%). Two patients reported cancer (breast cancer and pituitary adenoma ) Autoimmune conditions were present in four cases: three patients with SLE (2.6%) and one patient with Sjogren’s syndrome (SS). Thirty-six (31.3%) patients were underweight and 19 (16.5%) were overweight with no obese patients (the mean BMI in the whole group: 20.42±3.64). There were 14 (12.1%) ever smokers in the study cohort with the mean of number of packs-years of 11.58±14.95. Psychiatric comorbidities associated with PI in unadjusted (OR=0.649, 95% CI=0.120, 1.178, P=0.017) and adjusted models (OR=0.506, 95% CI=0.082, 0.930, P=0.020). After stratification for AQP4-IgG no significant difference in frequency of comorbidities and outcomes were observed.
Conclusions
Our results showed that half the patients had comorbidities, suggesting screening for comorbidity as part of NMOSD care.