Abstract Details

Title Demographic and Relapse Correlates of Treatment Change in NMOSD Patients: Analysis of the CIRCLES Study

Topic Autoimmune Neurology

Presentation(s) Autoimmune Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 013

Objective

To assess potential relationships among gender/race/ethnic characteristics, relapse or annual relapse rate (ARR) with time to first treatment change (TFTC) in neuromyelitis optica spectrum disorder (NMOSD) patients in the CIRCLES study from 2013–2020.

Background NMOSD is a rare autoimmune disease with different prevalence and relapse profiles in distinct populations. Whether such features associate with the likelihood to change maintenance treatment regimen is unclear. Here, real-world data were analyzed for correlations with change in treatment regimen in patients with NMOSD.

Design/Methods

CIRCLES is an IRB-approved longitudinal, observational study conducted at 15 medical centers in North America. Patients having at least 60 days of follow-up and on-study maintenance treatment were evaluated. Mean ARR was estimated using Poisson models, while likelihood of treatment change was estimated using Cox proportional hazards models for gender and racial/ethnic cohorts.

Results Among 542 patients, mean on-study ARR differed per gender and race/ethnicity: females – Hispanic (0.28); White (0.23); Black (0.18); Asian (0.06); males – Black (0.48); Asian (0.33); Hispanic (0.22); White (0.15). While gender alone did not significantly correlate with ARR, stratifying by gender/race/ethnicity revealed significant differences: females – Asian lower than Hispanic (p=0.009) or White (p=0.018) but not Black (p=0.065); males – Black higher than White (p=0.045) but not Hispanic (p=0.342) or Asian (p=0.563). Overall, a significant difference in ARR was seen between Asian and Hispanic cohorts (p=0.031). An on-study relapse was strongly correlated with likelihood for treatment change (p<0.001).

Conclusions

In CIRCLES patients, gender/race/ethnicity differences in ARR did not yield differences in TFTC, despite strong association of relapse with subsequent treatment change. Results suggest specific patient cohorts may be predisposed or likely to change treatment, based on NMOSD disease activity or other factors. These findings may aid in optimizing therapy to enhance quality of life in patients with NMOSD as the field enters the new era of approved therapies.

Authors/Disclosures
Shervin Gholizadeh PRESENTER	Mr. Gholizadeh has received personal compensation for serving as an employee of Genentech.
Alex Exuzides	Alex Exuzides has nothing to disclose.
	No disclosure on file
	No disclosure on file
Michael Waltz	No disclosure on file
John W. Rose, MD, FAAN (Imaging and Neurosciences Center)	The institution of Dr. Rose has received research support from National Multiple Sclerosis Society. The institution of Dr. Rose has received research support from Guthy Jackson Charitable Foundation. The institution of Dr. Rose has received research support from NIH . The institution of Dr. Rose has received research support from VA. The institution of Dr. Rose has received research support from Biogen. The institution of Dr. Rose has received research support from Friends of MS. Dr. Rose has received intellectual property interests from a discovery or technology relating to health care.
Anna Jolley (University of Utah, Data Coordinating Center)	Ms. Jolley has nothing to disclose.
Jacinta Behne (The Guthy-Jackson Charitable Foundation)	Ms. Behne has nothing to disclose.
Megan Behne (The Guthy-Jackson Charitable Foundation)	Ms. Behne has received personal compensation for serving as an employee of The Guthy-Jackson Charitable Foundation. Ms. Behne has received personal compensation in the range of $50,000-$99,999 for serving as a Independent Contractor with The Guthy-Jackson Charitable Foundation.
	No disclosure on file
Terry Smith	Terry Smith has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Horizon. Terry Smith has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Immunovant. Terry Smith has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Terry Smith has received intellectual property interests from a discovery or technology relating to health care.
Michael R. Yeaman, PhD (UCLA)	Dr. Yeaman has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Yeaman has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Genentech-Roche. Dr. Yeaman has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. The institution of Dr. Yeaman has received research support from National Institutes of Health. The institution of Dr. Yeaman has received research support from U.S. Department of Defense. Dr. Yeaman has received intellectual property interests from a discovery or technology relating to health care. Dr. Yeaman has received intellectual property interests from a discovery or technology relating to health care.
	No disclosure on file
Lawrence Cook, PhD (University of Utah Data Coordinating Center)	The institution of Dr. Cook has received research support from CDC. The institution of Dr. Cook has received research support from The Guthy-Jackson Charitable Foundation. The institution of Dr. Cook has received research support from Utah Highway Safety Office. The institution of Dr. Cook has received research support from NIH.

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