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Abstract Details

Neuromyelitis Optica Spectrum Disorder (NMOSD): Epidemiology, Treatments, and Outcomes in a Single Center
Autoimmune Neurology
P14 - Poster Session 14 (8:00 AM-9:00 AM)
15-002

Provide a comprehensive, contemporary description of epidemiology and clinical and economic outcomes of Neuromyelitis Optica Spectrum Disorder (NMOSD) in a specialized academic center.
NMOSD is a relapsing, autoimmune, inflammatory central nervous system disorder primarily affecting the optic nerves and spinal cord.  Longitudinal natural history studies are lacking on NMOSD patients in the recent era of more accurate diagnostic testing and greater treatment availability. We present epidemiological, treatment, and functional outcome data from a single academic center, including an analysis of downstream economic sequelae, with additional consideration to misdiagnoses and treatment-related comorbidity. 
We retrospectively identified 171 unique patients within the University of Utah Health System with an ICD code of NMOSD ever listed in the medical record between 2006 through 2019.  Cases were independently reviewed by two neuroimmunologists, who confirmed that they met Wingerchuk 2015 criteria for NMOSD.  Patients were further divided into 3 subcategories for analysis: AQP4 autoantibody positivity, MOG autoantibody positivity, and seronegative NMOSD. 

Our cohort featured 47 AQP4 positive, 12 AQP4 negative, and 14 MOG positive NMOSD patients. They were 75% white, 73% female, and 73% were from Utah. MOG patients were on average younger at diagnosis than their counterparts. For the cohort overall, the most common relapse type at initial NMOSD diagnosis was optic neuritis (62%) followed by transverse myelitis (19%), with the remainder being mixed or unknown.  Treatment for multiple sclerosis was given to 6 patients who were subsequently diagnosed with NMOSD. Baseline Charlson Comorbidity Index was higher in AQP4 positive patients than in their counterparts.

The experience to date demonstrates this study to be a good resource to provide a comprehensive description of the epidemiology of NMOSD in a large western United States referral center, as well as an updated understanding of NMOSD outcomes in an era of multiple immunotherapies, and highlights variables affecting outcomes.
Authors/Disclosures
Robert Kadish, MD
PRESENTER 		Dr. Kadish has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. The institution of Dr. Kadish has received research support from Alexion Pharmaceuticals.
No disclosure on file
Imran Tanvir Imran Tanvir has received personal compensation for serving as an employee of Alexion Pharmaceuticals. Imran Tanvir has received stock or an ownership interest from Alexion Pharmaceuticals.
No disclosure on file
Adrian Kielhorn Adrian Kielhorn has received personal compensation for serving as an employee of Alexion. Adrian Kielhorn has stock in Alexion.
No disclosure on file
Stacey Clardy, MD, PhD, FÂ鶹´«Ã½Ó³»­ (University of Utah) Dr. Clardy has received personal compensation for serving as an employee of Veterans Health Administration (VHA). Dr. Clardy has received personal compensation for serving as an employee of University of Utah Health. Dr. Clardy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AstraZeneca/Alexion. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen/Horizon. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Arialys. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kyverna. Dr. Clardy has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology/Â鶹´«Ã½Ó³»­ Publications. The institution of Dr. Clardy has received research support from NIH/NINDS. The institution of Dr. Clardy has received research support from SRNA. The institution of Dr. Clardy has received research support from Alexion/AstraZeneca. The institution of Dr. Clardy has received research support from Kyverna. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a Â鶹´«Ã½Ó³»­ Summer Meeting CoDirector Travel and Lodging with Â鶹´«Ã½Ó³»­. Dr. Clardy has received personal compensation in the range of $500-$4,999 for serving as a Grand Rounds Travel/Lodging/Honoraria with U of Iowa, Miami, Stanford, Barrow, Advent Health Florida, Beaumont Health, CCF, Emory, Penn State Health, Mayo Clinic, Walter Reed.