Author Of 2 Presentations
P0719 - Incidence of NMOSD relapses and seasonal influence in an equatorial country cohort (ID 1809)
Abstract
Background
Information about seasonal distribution of Neuromyelitis optica spectrum disorders (NMOSD) attacks have rarely been described and are non-conclusive.
Objectives
To quantify the seasonal variation of relapses in Neuromyelitis Optica Spectrum Disorders in a country at the equator.
Methods
Descriptive retrospective cohort study between January 2008 and December 2019. Data of demographic and clinical information including relapses and follow up of all patients with NMOSD at Instituto Neurológico de Colombia (INDEC) were recorded. The annual, monthly and intra-annual seasonal variation of NMOSD relapses were quantified. Seasonal temporal variation was defined as first dry season (FDS) (January-March), first rainy season (FRS) (April-June), second dry season (SDS) (July-September) and second rainy season (SRS) (October-December).
Results
There were 99 patients and 242 relapses (191 with data of the month of admission). The mean age was 45±14 and 90 (88%) were women. 87 (88%) patients were AQP4 Ab (+). Spinal cord 127 (52%) followed by optic neuritis 89 (36.5%) were the most common relapses. Attacks were treated with methylprednisolone 99 (54.5%) and methylprednisolone + plasmapheresis 56 (30.8%). Analysis of 191 relapses per month, showed higher frequency of attacks in November and December. The incidence of seasonal temporal variation (rainy or dry season) was FDS 21%, FRS 22.4%, SDS 26.2% and SRS 30.4% respectively. The incidence of relapses in rainy season compared to the dry season (52.8% vs 47.2%) was greater and this difference reached statistical significance (p= <0.05 U de Mann-Whitney).
Conclusions
NMOSD attacks tend to occur more frequently during the rainy season, further studies should focus on possible environmental risk factors as relapse triggers.
P0735 - Neuromyelitis Optica spectrum disorder, characterization of a population in a specialized center in Colombia (ID 1722)
Abstract
Background
Neuromyelitis Optica spectrum disorder (NMOSD) are inflammatory condition of central nervous system, predominantly targeting optic nerves and spinal cord, associated with IgG antibodies against aquaporin-4 (AQP4-IgG), with a prevalence of 0.51-4.4 cases/100,000 inhabitants; it mainly affects 30-40 years old women. Characterized by outbreaks of longitudinally extensive transverse myelitis (LETM) and optic neuritis (ON). In Colombia its prevalence is unknown.
Objectives
The aim is to describe and explore an association between AQP4-IgG and sociodemographic and clinical characteristics (1–3).
Methods
Retrospective multicenter cohort (January 2013 to June 2020) of patients with NMOSD 2015 criteria (4). Data obtained from electronic clinical records. Bivariate analysis with chi square test was performed to determine if AQP4-IgG serology is modified by initial symptom, comorbidities, EDSS, resonances (MRI) and disease modifying treatment. Median difference and correlation between current and baseline EDSS were calculated and evaluated, with age of diagnosis and disease evolution time. Relapse incidence rate was analyzed.
Results
30 patients, 82.3% women, median age 50.5 years with interquartile range (IQR 38-58), median age at diagnosis 44 years (IQR 32-53), and disease progression 3.85 years (IQR 2.03-8.53). Initial symptom was LETM in 41.2%, followed by ON (33.9%). 28.4% had hypertension, 20% another autoimmune disease (lupus and Sjögren, were more common) and 19.2% hypothyroidism. 92.3% received rituximab treatment, 3.08% azathioprine and 6% no treatment. 17.69% received initial management as multiple sclerosis. Median EDSS at admission was 2 (IQR 0-4.5) and last measurement 2.5 (IQR 1-5). Of 109 patients, 73.39% were AQP4-IgG positive. According to baseline and last control MRI, 45% (n=27/60) and 41.9% (n=13/31) had ON, and 22.01% (24/109) and 11.9% (n=13/109) LETM, respectively. In the last year, relapse incidence rate was 0.13 for each person-year-observed (95%CI 0.07-0.20). 12.3% of patients relapsed after the index event, median time to first relapse after index event was 25.8 months (IQR 8.28-66.82), and second 12.68 months (IQR 8.93-24.33). No association was found between AQP4-IgG serology and sociodemographic or clinical variables, nor correlation with EDSS (p> 0.05).
Conclusions
This Colombian NMOSD population is mainly women, with diagnostic age of 44 years, 92.3% on treatment with rituximab. Similar behavior to evidence in the literature was observed and no association was found between the evaluated variables.
Presenter Of 1 Presentation
P0735 - Neuromyelitis Optica spectrum disorder, characterization of a population in a specialized center in Colombia (ID 1722)
Abstract
Background
Neuromyelitis Optica spectrum disorder (NMOSD) are inflammatory condition of central nervous system, predominantly targeting optic nerves and spinal cord, associated with IgG antibodies against aquaporin-4 (AQP4-IgG), with a prevalence of 0.51-4.4 cases/100,000 inhabitants; it mainly affects 30-40 years old women. Characterized by outbreaks of longitudinally extensive transverse myelitis (LETM) and optic neuritis (ON). In Colombia its prevalence is unknown.
Objectives
The aim is to describe and explore an association between AQP4-IgG and sociodemographic and clinical characteristics (1–3).
Methods
Retrospective multicenter cohort (January 2013 to June 2020) of patients with NMOSD 2015 criteria (4). Data obtained from electronic clinical records. Bivariate analysis with chi square test was performed to determine if AQP4-IgG serology is modified by initial symptom, comorbidities, EDSS, resonances (MRI) and disease modifying treatment. Median difference and correlation between current and baseline EDSS were calculated and evaluated, with age of diagnosis and disease evolution time. Relapse incidence rate was analyzed.
Results
30 patients, 82.3% women, median age 50.5 years with interquartile range (IQR 38-58), median age at diagnosis 44 years (IQR 32-53), and disease progression 3.85 years (IQR 2.03-8.53). Initial symptom was LETM in 41.2%, followed by ON (33.9%). 28.4% had hypertension, 20% another autoimmune disease (lupus and Sjögren, were more common) and 19.2% hypothyroidism. 92.3% received rituximab treatment, 3.08% azathioprine and 6% no treatment. 17.69% received initial management as multiple sclerosis. Median EDSS at admission was 2 (IQR 0-4.5) and last measurement 2.5 (IQR 1-5). Of 109 patients, 73.39% were AQP4-IgG positive. According to baseline and last control MRI, 45% (n=27/60) and 41.9% (n=13/31) had ON, and 22.01% (24/109) and 11.9% (n=13/109) LETM, respectively. In the last year, relapse incidence rate was 0.13 for each person-year-observed (95%CI 0.07-0.20). 12.3% of patients relapsed after the index event, median time to first relapse after index event was 25.8 months (IQR 8.28-66.82), and second 12.68 months (IQR 8.93-24.33). No association was found between AQP4-IgG serology and sociodemographic or clinical variables, nor correlation with EDSS (p> 0.05).
Conclusions
This Colombian NMOSD population is mainly women, with diagnostic age of 44 years, 92.3% on treatment with rituximab. Similar behavior to evidence in the literature was observed and no association was found between the evaluated variables.