Abstract Details

Title Differences in Disease Patterns between Aquaporin-4 Antibody-Positive and Antibody-Negative Patients with Neuromyelitis Optica

Topic MS and Related Diseases

Presentation(s) P02 - (-)

Poster/Presentation
Number 138

Objective

Background BACKGROUND: NMO is an autoimmune disorder of the CNS characterized by optic neuritis and transverse myelitis. Since the discovery of NMO-specific autoantibody to aquaporin-4 channels (NMO-IgG), seropositivity status has been incorporated into the diagnostic criteria. However, there is a subset of patients who remain seronegative but display the full clinical spectrum of the disease.

Design/Methods DESIGN/METHODS: NMO patients were recruited at UBC Hospital MS and NMO clinic. Clinical severity and patient characteristics of those meeting the 2006 NMO diagnostic criteria were reviewed according to their NMO-IgG status. NMO-IgG antibodies were tested in at least one of four independent laboratories. Data was analyzed with a Mann Whitney-U test.

Results RESULTS: 46 of 425 consecutive patients tested met 2006 diagnostic criteria for NMO. 26 were seropositive and 20 were seronegative. The female to male ratio (5:1) as well as the Asian to Caucasian ratio (1.5:1) in the seropositive group were significantly higher than the seronegative group (1:1, 0.6:1 respectively). Seropositive patients were younger at disease onset (35 vs 39) and had longer disease duration (13 vs 9 yrs). The time from onset to first relapse (3.1 vs 1.8 yrs) and time to reach diagnosis of NMO (6.2 vs 3.4 yrs) was longer in the seropositive group compared to seronegative patients, although not statistically significant. Greater proportion of patients reached EDSS scores >6 in the seropositive group (23% vs. 20%), but there was no difference in the fraction of patients who became wheelchair bound. Time to reach wheelchair dependence was longer for seronegative patients (9.5 vs 7.9 yrs).

Conclusions CONCLUSIONS: There are clinical differences in the disease patterns between NMO-IgG positive and negative patients, with earlier disease onset, longer disease duration, and faster time to disability in the seropositive group.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
Ian T. Rossman, MD, PhD (Akron Children's Hospital)	No disclosure on file
Kazuo Fujihara, MD (Tohoku University, School of Medicine)	Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck Boipharma. Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Japan Tobacco. Dr. Fujihara has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Fujihara has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Mitsubishi-Tanabe. Dr. Fujihara has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Chugai/Roche. Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Fujihara has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Fujihara has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. The institution of Dr. Fujihara has received research support from Ministry of Health, Welfare and Labor of Japan. Dr. Fujihara has received personal compensation in the range of $10,000-$49,999 for serving as a speaker, chair, etc with Novartis. Dr. Fujihara has received personal compensation in the range of $5,000-$9,999 for serving as a speaker, chair, etc with Biogen. Dr. Fujihara has received personal compensation in the range of $10,000-$49,999 for serving as a speaker, chair, etc with Mitsubishi-Tanabe. Dr. Fujihara has received personal compensation in the range of $10,000-$49,999 for serving as a apeaker, chair, etc with Chugai/Roche. Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving as a speaker, chair, etc with Alexion. Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving as a chair, speaker with Asahi Kasei Medical. Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving as a speaker with Eisai. Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving as a speaker, chair with Teijin.
Toshiaki Takahashi (Tohoku Univ-Dept Of Neuro)	No disclosure on file
Anthony Traboulsee, MD (University of British Columbia)	Dr. Traboulsee has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Traboulsee has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Traboulsee has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Traboulsee has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Traboulsee has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Traboulsee has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for EMD Serono. Dr. Traboulsee has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Roche. The institution of Dr. Traboulsee has received research support from Roche. The institution of Dr. Traboulsee has received research support from Consortium of MS Centers. The institution of Dr. Traboulsee has received research support from MS Canada. Dr. Traboulsee has received personal compensation in the range of $500-$4,999 for serving as a Workshop Chair with Consortium of MS Centers.

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