Population-based head-to-head comparison of the clinical characteristics and epidemiology of AQP4 antibody-positive NMOSD between two European countries.

BACKGROUND

Population-based clinical studies in neuromyelitis optica spectrum disorder (NMOSD) and epidemiological and clinical comparisons of White ethnicities are missing. In a large population-based international cohort, we extensively characterized aquaporin-4 antibody seropositive (AQP4-Ab+) NMOSD, and also compared the clinical, radiological and epidemiological features between two European populations residing in different areas.

METHODS

Between self-reported Danish and Hungarian ethnicities, we compared the population-based clinical features, disability outcomes, and death of 134 AQP4-Ab+ NMOSD cases fulfilling the 2015 International Panel for NMO Diagnosis (IPND) criteria. For precise comparison of epidemiology, we conducted a population-based head-to-head comparative study of the age-standardized prevalence (January 1, 2014) and incidence (2007-2013) of AQP4-Ab+ NMO/NMOSD among adults (≥16 years) in Denmark (4.6 million) and Hungary (6.4 million) by applying 2015 IPND (NMOSD) criteria and 2006 Wingerchuk (NMO).

RESULTS

Danes were more likely to present with transverse myelitis and were more affected by spinal cord damage on long-term disability. Hungarians presented most often with optic neuritis, although visual outcome was similar in the groups. No differences were observed in sex, disease course, relapse rate, autoimmune comorbidity, mortality, brain MRI, and treatment strategies. The age-standardized prevalence estimates of AQP4-Ab+ NMOSD (2015 IPND criteria) in Denmark vs. Hungary were 0.66 vs. 1.43 (/100,000) while incidence rates were 0.04 vs. 0.11 (/100,000 person-years); similar differences were found based on the 2006 NMO criteria.

CONCLUSIONS

This head-to-head comparative study indicates different disease characteristics and epidemiology among White populations in Europe, and substantiates the need for population-based genetic and environmental studies in NMOSD.

Informations de copyright

Copyright © 2021. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest Dr. Papp has received support for scientific meetings from Merck and Sanofi Genzyme and honoraria for lecturing from Alexion. K. Trones has no conflict of interest. Dr. Magyari has served on scientific advisory board for Biogen, Sanofi, Roche, Novartis, Merck, Abbvie, has received honoraria for lecturing from Biogen, Merck, Novartis, Sanofi, Genzyme, has received research support and support for congress participation from Biogen, Genzyme, Roche, Merck, Novartis. Dr. Koch-Henriksen has received support for participation in congresses and symposia by Biogen, Merck, Novartis, Sanofi Genzyme, and Teva, and has received fee for lecturing by Novartis. Dr. Iljicsov has received support for congress participation and speaker honoraria from Biogen, Human Bioplazma, Merck, Novartis, Sanofi Genzyme and Teva. Dr. Rajda: congress invitation from Roche and Biogen; honoraria for lecturing from Teva. Dr. Nielsen has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Sanofi-Genzyme, Biogen Denmark, Novartis, Merck. Dr. Lovas has no conflict of interest. Dr. Rozsa Dr has no conflict of interest. Kristiansen has no conflict of interest. Dr. Stenager has no conflict of interest. Dr. Frederiksen has received no funding to support the presented work. She has served on scientific advisory boards for and received funding, honoraria from Biogen Idec, Merck Serono, Sanofi-Aventis, Teva, Novartis and Almirall. Dr. Komoly has received honoraria for talks and payment for occasional consultancy or research funding from TEVA, Bayer-Schering, Merck, Biogen. Dr. Sellebjerg has served on scientific advisory boards, been on the steering committees of clinical trials, served as a consultant, received support for congress participation, received speaker honoraria, or received research support for his laboratory from Biogen, Merck, Novartis, Roche, Sanofi Genzyme and Teva. Dr. Petersen: research support to the MS clinic at Aarhus University Hospital from Merck, Alexion, Roche, Biogen, Novartis, Sanofi. Dr. Illes has served on scientific advisory boards, received support for congress participation, received speaker honoraria, or received research support for his laboratory from Biogen, Merck, Roche, Sanofi Genzyme, and was a member of clinical endpoint committees in clinical trials of NMOSD but it has no conflict of interest with the current study.