Hospital Alemán
Neuroimmunology Unit, Department of Neuroscience

Author Of 3 Presentations

Neuromyelitis Optica and Anti-MOG Disease Poster Presentation

P0757 - The neutrophil-to-lymphocyte ratio in aquaporin-4-positive NMOSD patients: A Latin American multicenter study (ID 1034)

Abstract

Background

Neutrophil-to-lymphocyte ratio (NLR) has been investigated in many autoimmune diseases as a marker of both inflammation and disease activity. So far, the role of NLR in aquaporin-4(AQP4)-ab-positive neuromyelitis optica spectrum disorders (NMOSD) is uncertain due to a lack of data.

Objectives

The aim of this study was to evaluate NLR in AQP4-ab-positive NMOSD patients at disease onset and determine their clinical significance during follow-up.

Methods

We retrospectively included and reviewed the medical records of all recent/newly diagnosed treatment-naïve AQP4-ab-positive NMOSD patients (n=90) according to the 2015 international diagnostic criteria. Additionally, demographic, clinical, paraclinical (e.g. new/enlarging or contrast-enhancing lesions) and prognostic (via EDSS) data at 12 and 24 months were also evaluated. NRL was calculated as the absolute count of neutrophils divided by the absolute count of lymphocytes from peripheral blood samples. Three-hundred and sixty-five healthy subjects who underwent routine physical exam were included as controls. Multivariate regression analysis was used to describe and identified independent association between log-transformed NLR and clinical (relapses and EDSS change) as well as MRI activity (new/enlarging and/or contrast-enhancing MRI lesions). P<0.05 was considered as significant.

Results

NLR was higher in NMOSD patients during the first relapse compared with controls (2.9 ±1.6vs. 1.8 ±0.6;p<0.0001). Regardless of immunosuppressants’ initiation at disease onset, NLR continued to be higher in NMOSD patients at 12 (2.8 ±1.3;p<0.0001) and 24 (3.1 ±1.6;p<0.0001) months compared with controls. No association was observed at 12 and 24 months between log-transformed NLR and the presence of relapses ([OR=0.66, CI95%0.28-1.58, p=0.36] and [OR=0.76, CI95%0.30-1.93, p=0.57], respectively), new/enlarging and/or contrast-enhancing MRI lesions ([OR=1.72, CI95%0.58-5.04, p=0.32] and [OR=0.42, CI95%0.47-2.52, p=0.82], respectively) and physical disability ([OR=-0.21, CI95%-1.04-0.61, p=0.60] and [OR=-0.15, CI95%-1.01-0.69, p=0.71], respectively).

Conclusions

This study suggested that NLR may be a marker of inflammation in AQP4-ab-positive NMOSD patients. However, a higher NLR was not an independent predictor of clinical or radiological disease activity in our model.

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Patient-Reported Outcomes and Quality of Life Poster Presentation

P1033 - Health-related quality of life in relapsing multiple sclerosis patients from Argentina: impact of clinical features and coping strategies (ID 1032)

Presentation Number
P1033
Presentation Topic
Patient-Reported Outcomes and Quality of Life

Abstract

Background

Multiple sclerosis (MS) patients have reported decreased health-related quality of life (HRQoL). Identifying factors that contribute to a worse HRQoL is needing in order to improve the HRQoL of these patients.

Objectives

We aimed to investigate the HRQoLin an Argentinean population of MS patients and their correlation with clinical variables and coping strategies.

Methods

Nationwide cross-sectional study. Screening instruments: Demographics and clinical data, HRQoL (MS Impact Scale, [MSIS-29]), Fatigue Severity Scale and physical disability (self-administrated Expanded Disability Status Scale, [EDSS]) and coping strategies (Brief Coping Orientation to Problems Experienced, [COPE-28]).

Results

We included 249 (74.7% women) MS patients with a mean age at survey of 38.6 (±10.7), a MS duration of 7.3 years (range: 1-43 years) and a mean EDSS of 1.9 (±1.8). The multivariate analysis via linear regression showed: lower fatigue scores and higher EDSS score, perception of severity of MS score and dysfunctional (maladaptive) coping strategies score significantly correlated with both higher (worse) HRQoL total (from p=0.009 to p<0.0001) and MSIS-physical scores (from p=0.04 to p<0.0001). Additionally, higher age and lower fatigue, dysfunctional coping strategies and perception of severity of MS scores were significantly correlated with worse MSIS-psychological (from p=0.006 to p<0.0001). An inverse correlation between live alone (p=0.04) and emotion-focused strategies (p=0.02) was significantly associated with a better MSIS-psychological.

Conclusions

This study showed a negative impact of physical disability and maladaptive coping strategies on HRQoL in MS patients from Argentina. Therefore, it would be necessary to increase interdisciplinary interventions and based on adaptive coping strategies to improve the HRQoL of these patients.

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Gender Differences, Hormones and Sex Chromosomes Poster Presentation

P1120 - Disparities in access to health care for women with multiple sclerosis in Argentina (ID 1509)

Abstract

Background

Disparities about health care access in females were previously reported. In Argentina, previous studies have shown the unequal access to health care in MS patients stratified by health coverage, but no information were obtained regarding disparities in the access by gender

Objectives

The objective of the study was to evaluate whether disparities in the access to healthcare was identified in women with multiple sclerosis (MS) in Argentina.

Methods

A cross-sectional study based on a self-administered survey was carried in 13 provinces from Argentina. We asked about demographic and clinical aspects of the disease as well as the access and barriers to MS care through self-report measures on waiting time for both neurological visits and MRI test, disease modifying treatment (DMTs) access and waiting time for delivery of DMTs. We applied multivariate analysis via both logistic and lineal regression to evaluate the impact of different factors on health care resources utilization

Results

We included 219 patients, mean age 39 (± 16) years and a female predominance 149 (68%). There were no differences between females and males in RRMS phenotype (92% vs. 89%), mean EDSS (2.5 ± 1 vs. 2.2 ± 1.3), mean age at disease onset (38±4 vs. 36 ±5 years) and working status (currently full time employed 63% vs. 68%) respectively. 97% of males vs. 89% of females received DMDs (p=0.02). No differences in neurological visits between females and males (at least 2 visits during the last year) (98% vs. 95%) neither MRI test (93% vs. 97%) was identified, respectively. Females reported longer waiting time for delivery of first DMDs (7.1 ±2 vs. 5.1 ±1.1 weeks, p=0.02) and longer waiting time for delivery of DMDs at follow-up DMDs (4.1 ±0.6 vs. 3.1 ±1 weeks, p=0.03). No differences in legal actions were identified between gender (22 % females vs. 19 % males).

Conclusions

despite no differences between demographic and clinical aspects, we identified an increased time for delivery of DMTs in female MS patients compared to males in our region.

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