Neuromyelitis optica spectrum disorders in Arabian Gulf (NMOAG); establishment and initial characterization of a patient registry.

To describe the clinical and radiological characteristics of neuromyelitis optica spectrum disorders (NMOSD) patients from the Arabian Gulf relative to anti-aquaporin 4 antibody serostatus. Retrospective multicentre study of hospital records of patients diagnosed with NMOSD based on 2015 International Panel on NMOSD Diagnosis (IPND) consensus criteria. One hundred forty four patients were evaluated, 64.3% were anti-AQP4 antibody positive. Mean age at onset and disease duration were 31±12 and 7 ± 6 years respectively. Patients were predominantly female (4.7:1). Overall; relapsing course (80%) was more common than monophasic (20%). Optic neuritis was the most frequent presentation (48.6%), regardless of serostatus. The proportion of patients (54.3%) with visual acuity of ≤ 0.1 was higher in the seropositive group (p = 0.018). Primary presenting symptoms of transverse myelitis (TM) were observed in 29% of patients, and were the most significant correlate of hospitalization (p<0.001). Relative to anti-APQ4 serostatus, there were no significant differences in terms of age of onset, course, relapse rates or efficacy outcomes except for oligoclonal bands (OCB), which were more often present in seronegative patients (40% vs.22.5%; p = 0.054). Irrespective of serostatus, several disease modifying therapies were instituted including steroids or immunosuppressives, mostly, rituximab and azathioprine in the cohort irrespective of serostatus. The use of rituximab resulted in reduction in disease activity. This is the first descriptive NMOSD cohort in the Arabian Gulf region. Seropositive patients were more prevalent with female predominance. Relapsing course was more common than monophasic. However, anti-AQP4 serostatus did not impact disease duration, relapse rate or therapeutic effectiveness. These findings offer new insights into natural history of NMOSD in patients of the Arabian Gulf and allow comparison with patient populations in different World regions.

Informations de copyright

Copyright © 2019 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest EN, AT, AK, MF, SN, MZ, SF, AA.A, JA, MJ. TA, AA, ME, RN, AG, IA, AM, NO, MQ, SA, KH has nothing to disclose E.Shosha has received honoraria for scientific lectures from Biologix, Merck, Hikma, travel payment from, Biologix, Sanofi, Merck, and Roche and served on the scientific advisory board for Biologix, Merck, and Sanofi. A. Al Asmi received honoraria for serving in scientific advisory board from Novartis, Merck, and Roche and travel payment from, Biologix, Bayer, Sanofi, Merck, Novartis, and Roche. J. Inshasi received honoraria for serving in scientific advisory board meetings from Biogen, Novartis, Merck, Sanofi and Roche Y. Al Malik received Compensation for advisory board participation and conference travel (Genzyme, Merck, and Roche). H. Alnajashi received honoraria as a speaker from Biogen, Novartis, and Roche. G. Altowaijri received honoraria for speaking for Novartis and advisory board for genzyme. F. Abdulla served in advisory board for Roche and Novartis Ibtisam A.Thubaiti worked on scientific advisory board for Merck-Serono and eceived speaker's honoraria from Novartis and Merck-Serono. R. Alroughani received honoraria as a speaker and for serving in scientific advisory board from Biogen, Bayer, Novartis, Merck, Sanofi and Roche.