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Abstract Details

Clinical determinants and therapeutic modifiers of relapse and disability outcomes in neuromyelitis optica spectrum disorder
Multiple Sclerosis
P1 - Poster Session 1 (5:30 PM-6:30 PM)
15-072
To investigate clinical determinants and therapeutic modifiers of relapses and disability in Neuromyelitis optica spectrum disorder (NMOSD).
NMOSD is associated with relapses that lead to accrual of significant neurological disability. Associations of these outcomes with patient characteristics and their modifiability over the long term by disease modifying therapies is not well understood. Further understanding of the clinical and therapeutic predictors of relapse and disability in NMOSD will help clinicians understand their patient’s disease course and may influence treatment decisions.  
A large international observational registry MSBase (NMOBase substudy) was used to identify patients diagnosed with aquaporin-4 (AQP4-Ab)- positive NMOSD. Multivariable proportional hazards model was used to study modifiers of relapse activity. Mixed effect regression model was used to study the determinants of disability. A secondary analysis aimed to validate the results of the primary analysis among patients with NMOSD with ‘any serostatus’.
202 AQP4-Ab-positive and 398 NMOSD patients with any AQP4-Ab serostatus were included (median follow-up duration 3.7 years). In AQP4-Ab- positive patients, age (hazard ratio [HR]=0.82 per decade, p=0.001), brainstem onset (HR=0.39, p=0.009), azathioprine (HR=0.45, p<0.001) and mycophenolate mofetil (HR=0.08, p=0.01) were associated with a reduced risk of relapse. A greater EDSS was associated with age (β=0.45 (per decade), p<0.001), disease duration (β=0.07 per year, p<0.001). A lower increase in EDSS was associated with treatment with azathioprine (β=-0.47, p<0.001), mycophenolate mofetil (β=-0.69, p=0.04) and rituximab (β=-0.32, p=0.038). These findings in both relapses and disability were replicated in the ‘any serostatus’ cohort.
In NMOSD, risk of relapses declines with age. Disability increases with age and disease duration. Treatment with azathioprine, rituximab and mycophenolate mofetil is associated with lower increase in disability, and azathioprine and mycophenolate mofetil are associated with a reduced risk of relapses.
Authors/Disclosures
Amy Kunchok, MBBS (Cleveland Clinic - Mellen Centre)
PRESENTER
Dr. Kunchok 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:Open Access Journal .
No disclosure on file
No disclosure on file
Eva Havrdova, MD (Neurologicka Klinika 1 LF UK) Dr. Havrdova has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Havrdova has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Dr. Havrdova has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Havrdova has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Havrdova has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Havrdova has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Havrdova has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi.
Raed Alroughani, MD, FAAN Dr. Alroughani 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, AstraZeneca, Novartis, Merck, Roche, Sanofi. Dr. Alroughani has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for AstraZeneca, Biogen, Novartis, Merck, Roche, Sanofi.
Murat Terzi, PhD (19 Mayis Universitesi) Dr. Terzi has nothing to disclose.
Bassem I. Yamout, MD, FAAN (Harley Street Medical Center) Dr. Yamout has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Yamout has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Yamout has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Yamout 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. Yamout has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi.
Jyh Yung Hor, MD (Penang General Hospital) No disclosure on file
Rana Karabudak, MD (Academic Neurologist) Dr. Karabudak has nothing to disclose.
Cavit Boz, MD Dr. Boz has nothing to disclose.
Serkan Ozakbas, MD (Department of Neurology Izmir University of Economics Medical Point Hospital) Dr. Ozakbas has nothing to disclose.
Francisco Javier Olascoaga Urtaza, MD No disclosure on file
Magdolna Simo, MD No disclosure on file
Franco Granella (Zeneca-UK) Franco Granella has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Franco Granella has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Franco Granella has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck Serono.
Francesco Patti, MD Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Almirall. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Meyers. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson and Johnson. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. The institution of Dr. Patti has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Almirall, Bayer, Biogen, Bristol Meyers and Squibb Merck, Roche, Sanofi, TEVA. Dr. Patti has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for University of Catania and AISM/FISM, Fondazione Italiana Sclerosi Multipla. Dr. Patti has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers in Neurology.
Pamela A. McCombe, MD (Dr PA McCombe Medical Pty Ltd) Dr. McCombe has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. McCombe has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. McCombe has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genzyme. The institution of Dr. McCombe has received research support from Motor Neurone Disease Resaerch Institute of Australia.
Tunde Csepany, MD (University of Debrecen) Dr. Csepany has nothing to disclose.
Bhim S. Singhal, MD, FAAN (Bombay Hospital Institute of Medical Sciences) The institution of Dr. Singhal has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Pfizer.
Roberto Bergamaschi Roberto Bergamaschi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Roberto Bergamaschi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Roberto Bergamaschi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Roberto Bergamaschi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Roberto Bergamaschi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Roberto Bergamaschi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Roberto Bergamaschi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi.
Yara D. Fragoso Yara D. Fragoso has nothing to disclose.
Talal M. Al-Harbi, MD, FAAN (King Fahad Specialist- Dammam) Dr. Al-Harbi has nothing to disclose.
Recai Turkoglu Recai Turkoglu has nothing to disclose.
Jeannette Lechner-Scott, MD, PhD, FRACP (HNEAH) The institution of Prof. Lechner-Scott has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. The institution of Prof. Lechner-Scott has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. The institution of Prof. Lechner-Scott has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. The institution of Prof. Lechner-Scott has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. The institution of Prof. Lechner-Scott has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for elsevier. The institution of Prof. Lechner-Scott has received research support from Merck. The institution of Prof. Lechner-Scott has received research support from Biogen.
Guy Laureys, MD, PhD (UZ Gent) The institution of Dr. Laureys has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. The institution of Dr. Laureys has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. The institution of Dr. Laureys has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. The institution of Dr. Laureys has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. The institution of Dr. Laureys has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Dr. Laureys 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. Laureys has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Laureys has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Laureys has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celgene. Dr. Laureys 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. Laureys has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck.
No disclosure on file
Eugenio Pucci (Neurologia via Santa Lucia) No disclosure on file
Patrizia Sola (Nuovo Ospedale Civile S. Agostino-Estense) Patrizia Sola has nothing to disclose.
No disclosure on file
Ayse Altintas, MD Dr. Altintas has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck . Dr. Altintas has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Deva. The institution of Dr. Altintas has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion.
Aysun Soysal, MD (Bakirkoy Hospital Of Mental Disorders And Neuro) Dr. Soysal has nothing to disclose.
Ostoja (Steve) Vucic, MBBS, FRACP (Concord Hosoital) Prof. Vucic has a non-compensated relationship as a Member-Advisory Board with Biogen Idec Australia that is relevant to AAN interests or activities. Prof. Vucic has a non-compensated relationship as a Honorarium with Merkc Serono Ausralia that is relevant to AAN interests or activities.
Francois Grand-Maison, MD (Francois Grand'Maison MD INC) Dr. Grand-Maison has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Grand-Maison has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Dr. Grand-Maison has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Serono. Dr. Grand-Maison has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Grand-Maison has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis .
Sara Eichau Madueno Sara Eichau Madueno has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Sara Eichau Madueno has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Sara Eichau Madueno has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Sara Eichau Madueno has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Sara Eichau Madueno has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Sara Eichau Madueno has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Novartis. Sara Eichau Madueno has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Sara Eichau Madueno has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sanofi. Sara Eichau Madueno has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Merck.
Guillermo Izquierdo Ayuso, MD (Servicio De Neurologia) Dr. Izquierdo Ayuso has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer, Biogen Idec, Novartis, Sanofi, Merck Serono, Roche, Actelion and Celgene. Dr. Izquierdo Ayuso has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genzyme, Novartis, Sanofi Aventis, Alexion.
Alessandra Lugaresi, MD (Istituto delle Scienze Neurologiche di Bologna) Dr. Lugaresi has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck Serono. Dr. Lugaresi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis Pharma. Dr. Lugaresi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi-Genzyme. Dr. Lugaresi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Lugaresi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Dr. Lugaresi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Lugaresi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mylan. Dr. Lugaresi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Sqibb. Dr. Lugaresi has a non-compensated relationship as a Speaker at meetings, participant in trials with Fondazione Italiana Sclerosi Multipla that is relevant to AAN interests or activities.
Marco Onofrj, MD Dr. Onofrj has nothing to disclose.
Maria Trojano (Policlinico - Bari) Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi_Genzyme. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sandoz. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi-Genzyme. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Maria Trojano has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen.
Mark Marriott, MBBS (Royal Melbourne Hospital) No disclosure on file
Helmut Butzkueven, MD, MBBS Dr. Butzkueven has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Oxford Health Policy Forum. The institution of Dr. Butzkueven has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. The institution of Dr. Butzkueven has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck. The institution of Dr. Butzkueven has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. The institution of Dr. Butzkueven has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Dr. Butzkueven has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for MSBase . The institution of Dr. Butzkueven has received research support from NHMRC. The institution of Dr. Butzkueven has received research support from Biogen. The institution of Dr. Butzkueven has received research support from Roche. The institution of Dr. Butzkueven has received research support from Novartis.
Ilya Kister, MD, FAAN (NYU School of Medicine) Dr. Kister has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech-Roche. Dr. Kister 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. Kister has received research support from Genentech. The institution of Dr. Kister has received research support from Novartis. Dr. Kister has received publishing royalties from a publication relating to health care.
Tomas Kalincik Tomas Kalincik has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi Genzyme. Tomas Kalincik has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Tomas Kalincik has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Tomas Kalincik has received personal compensation in the range of $500-$4,999 for serving as a Consultant for National Health and Medical Research Council. Tomas Kalincik has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MS Research Australia. Tomas Kalincik 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. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Tomas Kalincik 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 Genzyme. Tomas Kalincik 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. Tomas Kalincik has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Tomas Kalincik has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Tomas Kalincik has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for WebMD Global. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Novartis. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sanofi Genzyme. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Teva. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for BioCSL. Tomas Kalincik has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Merck. Tomas Kalincik has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Eisai. The institution of Tomas Kalincik has received research support from Biogen. The institution of Tomas Kalincik has received research support from Novartis. The institution of Tomas Kalincik has received research support from Genzyme. The institution of Tomas Kalincik has received research support from Roche. The institution of Tomas Kalincik has received research support from Celgene. The institution of Tomas Kalincik has received research support from Merck. The institution of Tomas Kalincik has received research support from MSBase Foundation. The institution of Tomas Kalincik has received research support from ARSEP and EDMUS Foundations. The institution of Tomas Kalincik has received research support from MS Research Australia. The institution of Tomas Kalincik has received research support from National Health and Medical Research Council. The institution of Tomas Kalincik has received research support from Australian Research Council. The institution of Tomas Kalincik has received research support from MS Society. The institution of Tomas Kalincik has received research support from Trish Foundation. Tomas Kalincik has a non-compensated relationship as a scientific leadership group chair with MSBase Foundation that is relevant to AAN interests or activities.