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Abstract Details

Trends in Delays to Immunotherapy in Patients with Autoimmune Encephalitis
Autoimmune Neurology
P9 - Poster Session 9 (5:00 PM-6:00 PM)
1-010

We examined temporal trends and identified factors associated with time to immunotherapy in patients with AE.

Early treatment of patients with autoimmune encephalitis (AE) is associated with improved long-term outcomes.

Patients diagnosed with probable or definite AE with symptomatic disease onset between January 1st, 2007, and December 31st, 2024, were identified at a single center (University Health Network [UHN], Toronto, ON, Canada). The primary outcome was the number of days from symptomatic onset to immunotherapy initiation. The association between time to treatment and year of symptomatic onset, antibody test results, reported ethnicity, requirement for intensive care unit (ICU) admission, and associated neoplasm was analyzed using multivariable linear regression adjusted for age and sex.

Among 91 patients with AE (59 females, 65%), 65 (71%) had positive antibody testing, and the median time to immunotherapy treatment was 45 days (range: 0−3316). Time to treatment decreased by 9.5% per year (CI95%: 2% to 16.5% decrease; p = 0.018), and was 66% lower in patients admitted to the ICU (CI95%: 31% to 84% decrease; p = 0.004). Delays were 232% longer in patients with GAD65 positive antibodies (CI95%: 9% to 918% increase; p = 0.035) compared to NMDAR positive antibodies (35% decrease; CI95%: 73% decrease to 55% increase; p = 0.3).

Since its inception as a distinct disease entity in 2007, time to immunotherapy in AE has significantly decreased. Patients with GAD65 antibodies experienced significantly longer delays to treatment, compared to NMDAR antibodies. The observed decrease in time to immunotherapy may reflect increased clinical recognition of AE, improved access to antibody testing, and the establishment of a dedicated AE clinic at UHN.
Authors/Disclosures
Justin T. Levinsky, MHSc
PRESENTER 		Mr. Levinsky has nothing to disclose.
Lana Sladoje, CRSA Miss Sladoje has nothing to disclose.
Mary Jane Lim-Fat, MD, FRCPC Dr. Lim Fat has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Servier. Dr. Lim Fat has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novocure. The institution of Dr. Lim Fat has received research support from Brain Cancer Canada.
Alexandra Muccilli, MD (Saint Michael's Hospital - Multiple Sclerosis Clinic) Dr. Muccilli 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. Muccilli 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. Muccilli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Muccilli has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion.
Gregory S. Day, MD, MSc, FAAN (Mayo Clinic) Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arialys Therapeutics. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for DynaMed (EBSCO Health). Dr. Day has or had stock in ANI Pharmaceuticals. The institution of Dr. Day has received research support from National Institutes of Health / NIA. The institution of Dr. Day has received research support from National Institutes of Health / NINDS. The institution of Dr. Day has received research support from Amgen Pharmaceuticals. The institution of Dr. Day has received research support from AVID Radiopharmaceuticals. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Presenter at Annual Meeting (CME) with 好色先生. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Content Development (CME) with PeerView, Inc. Dr. Day has received personal compensation in the range of $5,000-$9,999 for serving as a Content Development (CME) with Continuing 好色先生, Inc. Dr. Day has received personal compensation in the range of $5,000-$9,999 for serving as a Content Development (CME) with Ionis Pharmaceuticals. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a 好色先生al Case Development + Presentation (video) with PeerDirect (P\S\L Group). Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Content Development / Presentation (non-CME) with MJH Life Sciences (NeurologyLive). Dr. Day has a non-compensated relationship as a Clinical Director with Anti-NMDA Receptor Encephalitis Foundation that is relevant to AAN interests or activities.
Sarah Lapointe, MD (CHUM) Dr. Lapointe has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion.
Seth A. Climans, MD (London Health Sciences Centre) Dr. Climans has nothing to disclose.
Richard Wennberg, MD, PhD Dr. Wennberg has nothing to disclose.
David F. Tang-Wai, MD, FRCPC (Toronto Western Hospital/University Health Network) Dr. Tang-Wai has nothing to disclose.
Julien Hebert, MD (Toronto Western Hospital (University Health Network)) Dr. Hebert has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Paladin Labs. Dr. Hebert has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Gowling WLG. The institution of Dr. Hebert has received research support from Praxis Precision Medicine.