National Institute of Neurology and Neurosurgery

Author Of 2 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.

Collapse
Observational Studies Poster Presentation

P0905 - Real-world experience of ocrelizumab in multiple sclerosis patients in Latin America (ID 1307)

Speakers
Presentation Number
P0905
Presentation Topic
Observational Studies

Abstract

Background

Ocrelizumab was approved in March 2017 for the treatment of relapsing or primary progressive MS. Despite the abundance of information concerning the efficacy and safety of ocrelizumab in phase III clinical trials, there is scarce evidence regarding real world patient profiles

Objectives

The aim of this study was to evaluate patient profiles, effectiveness and persistence to treatment in patients who used ocrelizumab for the treatment of multiple sclerosis (MS) in Latin America (LATAM)

Methods

retrospective multicenter study in Argentina, Chile and Mexico. Medical record databases of patients who received ocrelizumab and were followed for at least 1 year before and after treatment initiation were analyzed. Demographic and clinical variables were described as well as the effectiveness outcomes that included the proportion of patients free from clinical relapses, from disability progression, from new or enlarging T2 or T1 gadolinium-enhancing lesions on annual MRI. The proportion of patients discontinuing the treatment and the reason were registered.

Results

A total of 81 patients were included. The most frequent phenotype was relapsing remitting MS in 64.2% of patients. The mean age at study entry was 41.3 ± 12 years and 51.8 % were women. A total of 38% had relapse activity during the previous 12 months of ocrelizumab initiation, with a mean relapse rate of 1.3 ±0.6 during that period. 75 % were free from clinical relapses and 91% were free from gadolinium enhancing lesions in RRMS. Ocrelizumab discontinuation during the first 12 months was observed in 3 patients (3.7%). The mean persistence observed during the first year follow up was 338 ± 24 days.

Conclusions

Our study is in line with previous randomized clinical trials and recent real-world studies describing patient profiles effectiveness and persistence to ocrelizumab treatment in MS patients in LATAM.

Collapse