Abstract Details

Title Risk factors related to relapse after first immunosuppressive treatment in patients with neuromyelitis optica spectrum disorders

Topic Multiple Sclerosis

Presentation(s) P14 - Poster Session 14 (8:00 AM-9:00 AM)

Poster/Presentation
Number 9-009

Objective

To describe risk factors related to relapse after the start of first immunosuppressive treatment (FIT) in patients with NMOSD.

Background Neuromyelitis optica spectrum disorders (NMOSD) are inflammatory central nervous system demyelinating entities that involve the central nervous system and mainly courses with optic neuritis (ON) and transverse myelitis (TM), which generally have poor or no recovery.

Design/Methods We performed a retrospective case-control study. We included patients from the demyelinating diseases registry at the INCMNSZ Neurology Department. We selected patients >18 years old that met the 2015 NMOSD international consensus diagnostic criteria. We obtained clinical and demographic variables, anti-aquaporin 4 antibody (Anti-AQP4) status, and treatments. We conducted a bivariate analysis (Chi2 and Odd Ratio [OR]) to determine the association of these variables with relapses after FIT. Significant variables were analyzed using a binary logistic regression model.

Results Ninety-five patients were analyzed. Eighty-six percent of patients were female. Median age was 45.5+14.9. The average disease duration was 6.8+4.6 years with an average of 2.3+1.2 relapses before FIT. On the bivariate analysis, age < 50 years (p=0.037, OR 2.82 [1.044-7.665]), positive anti-AQP4 status (p=0.027, OR 2.698[1.108-6.574]), either simultaneous or sequential ON/TM coexistence, (p=0.004, OR 4.222[1.657-10.765]) and azathioprine as FIT (p=<0.001, OR 5.18[2.023-13.151]) had a significant association. On binary logistic regression model, azathioprine as FIT (p=0.002, OR 5.564[1.890-16.38 1]), ON/TM coexistence (p=0.007, OR 4.648[1.527-14.149]) and age <50 years (p=0.020 OR 4.322 [1.263-14.795]) remained statistically significant, however, positive anti-AQP4 status (p=0.143) did not.

Conclusions

In this study, patients with NMOSD that receive azathioprine as FIT, are < 50 years old and have ON/TM coexistence had a greater risk of disease relapse after FIT. Simultaneous steroid use, dose and adherence to azathioprine therapy need further study.

Authors/Disclosures
Fernando Morales-Ramírez (Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán) PRESENTER	No disclosure on file
	No disclosure on file
Vanessa Barriga Maldonado, Sr., PhD	No disclosure on file

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Abstract Details