Abstract Details

Title NMO Onset Is More Rapid in North American Ethnic East Asians Compared to Caucasians

Topic MS and Related Diseases

Presentation(s) P02 - (-)

Poster/Presentation
Number 153

Objective

Background BACKGROUND: NMO occurs globally. However differences in prevalence, phenotype or prognosis may occur amongst various ethnic cohorts. These differences may be explained in part by genetics, environment and access to health care (diagnostic testing and expertise). Vancouver, Canada has a population of 2 million, 20% of which are east Asian ethnic (predominately Chinese ethnic), and a MS clinic that serves approximately 80% of the population with over 5000 active MS and NMO patients.

Design/Methods DESIGN/METHODS: NMO patients were prospectively recruited at a single center (UBC Hospital MS and NMO clinic) since 2008. NMO diagnosis was based on the 2006 criteria. Anti-aquaporin 4 antibodies were tested in at least one of 4 independent laboratories. Antibody negative NMO spectrum disorder (NMOSD) patients included those with longitudinally extensive spinal cord lesion (LESCL) or severe bilateral optic neuritis compatible with NMO.

Results RESULTS: Since 2008, 132/425 consecutive patients met criteria for NMO/NMOSD. 75% were women, 45% were Asian. 50 fulfilled NMO criteria, 60% were antibody positive for aquaporin 4. 31% of the 82 NMOSD patients were antibody positive. When only NMOSD patients with LESCL were include (N=58), the antibody positive rate increased to 43%. Seropositive NMO patients had a younger age at onset (35 vs 39 years, p=0.04). EDSS 6 was more common in seropositive patients (26% vs 18%). Asian patients fulfilled diagnostic criteria sooner than Caucasians (2.9 years versus 6.0 years).

Conclusions CONCLUSIONS: Antibodies to aquaporin 4 occur less frequently in NMOSD than NMO. Seropositive patients had a younger age of onset and a worse prognosis. Asian patients had lower rates of seropositive serology for aquaporin 4 antibodies. However these patients had a more rapid disease course in terms of fulfilling diagnostic criteria suggesting potential differences in genetic factors that modulate disease course.

Authors/Disclosures
Anthony Traboulsee, MD (University of British Columbia) PRESENTER	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.
	No disclosure on file
Toshiaki Takahashi (Tohoku Univ-Dept Of Neuro)	No disclosure on file
	No disclosure on file
Robert L. Carruthers, MD	Dr. Carruthers has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Carruthers has received personal compensation in the range of $0-$499 for serving as a Consultant for Roche and Genentech. The institution of Dr. Carruthers has received research support from Roche and Genentech .
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.

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