Mortality of the Danish Nationwide AQP4 Antibody-Seropositive Neuromyelitis Optica Spectrum Disorder Patient Cohort.

Journal

Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060

Informations de publication

Date de publication:
12 Mar 2024
Historique:
medline: 28 3 2024
pubmed: 28 3 2024
entrez: 28 3 2024
Statut: ppublish

Résumé

We aimed to evaluate the mortality of patients with AQP4 antibody-seropositive (AQP4-Ab+) neuromyelitis optica spectrum disorder (NMOSD) in Denmark compared with that in the general population. We identified patients with AQP4-Ab+ NMOSD fulfilling the 2015 International Panel for Neuromyelitis Optica Diagnosis (IPND) criteria from multiple sources (laboratories and the Danish Multiple Sclerosis Registry). We obtained detailed information about patients from hospital records and about the general population matched on age, sex, and calendar year from Statistics Denmark. We calculated standardized mortality ratio (SMR), excess number of deaths per 1,000 person-years (EDR), and life expectancies compared with those of the matched general population. We examined predictive factors of mortality and the cause of death. Of 66 patients with AQP4-Ab+ NMOSD between 2008 and 2020, 15 died. Overall, the SMR was 2.54 (95% CI 1.47-4.09), and the EDR was 16.8 (95% CI 4.6-34.3). The median life expectancy for patients with AQP4-Ab+ NMOSD was 64.08 years (95% CI 53.02-83.9), compared with 83.07 years for the general population. Risk of death over time was increased in the patient population with a hazard ratio (HR) of 2.22 (1.34-3.68; AQP4-Ab+ NMOSD is associated with increased mortality and shorter life expectancy compared with that in the general population, underlining the need for highly effective treatment approaches.

Sections du résumé

BACKGROUND AND OBJECTIVES OBJECTIVE
We aimed to evaluate the mortality of patients with AQP4 antibody-seropositive (AQP4-Ab+) neuromyelitis optica spectrum disorder (NMOSD) in Denmark compared with that in the general population.
METHODS METHODS
We identified patients with AQP4-Ab+ NMOSD fulfilling the 2015 International Panel for Neuromyelitis Optica Diagnosis (IPND) criteria from multiple sources (laboratories and the Danish Multiple Sclerosis Registry). We obtained detailed information about patients from hospital records and about the general population matched on age, sex, and calendar year from Statistics Denmark. We calculated standardized mortality ratio (SMR), excess number of deaths per 1,000 person-years (EDR), and life expectancies compared with those of the matched general population. We examined predictive factors of mortality and the cause of death.
RESULTS RESULTS
Of 66 patients with AQP4-Ab+ NMOSD between 2008 and 2020, 15 died. Overall, the SMR was 2.54 (95% CI 1.47-4.09), and the EDR was 16.8 (95% CI 4.6-34.3). The median life expectancy for patients with AQP4-Ab+ NMOSD was 64.08 years (95% CI 53.02-83.9), compared with 83.07 years for the general population. Risk of death over time was increased in the patient population with a hazard ratio (HR) of 2.22 (1.34-3.68;
DISCUSSION CONCLUSIONS
AQP4-Ab+ NMOSD is associated with increased mortality and shorter life expectancy compared with that in the general population, underlining the need for highly effective treatment approaches.

Identifiants

DOI: 10.1212/WNL.0000000000209147 PMID: 38546185
pubmed: 38546185
doi: 10.1212/WNL.0000000000209147
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e209147

Auteurs

Viktoria Papp (V)

From the Department of Neurology (V.P., Z.I.), Odense University Hospital, University of Southern Denmark; Danish Multiple Sclerosis Center and Danish Multiple Sclerosis Registry (M.M., F.S., J.L.B.), Copenhagen University Hospital-Rigshospitalet, Glostrup; Department of Clinical Medicine (M.M., F.S., J.L.B.), Faculty of Health and Medical Sciences, University of Copenhagen; Open Patient Data Explorative Network (S.M.), Odense University Hospital and Research Unit OPEN, Department of Clinical Research, University of Southern Denmark; Department of Neurology (K.B.S.), Aarhus University Hospital; Danish Multiple Sclerosis Center (H.B.S.), Copenhagen University Hospital-Rigshospitalet, Glostrup; and Department of Clinical Immunology (A.C.N.), Odense University Hospital, Denmark.

Melinda Magyari (M)

From the Department of Neurology (V.P., Z.I.), Odense University Hospital, University of Southern Denmark; Danish Multiple Sclerosis Center and Danish Multiple Sclerosis Registry (M.M., F.S., J.L.B.), Copenhagen University Hospital-Rigshospitalet, Glostrup; Department of Clinical Medicine (M.M., F.S., J.L.B.), Faculty of Health and Medical Sciences, University of Copenhagen; Open Patient Data Explorative Network (S.M.), Odense University Hospital and Research Unit OPEN, Department of Clinical Research, University of Southern Denmark; Department of Neurology (K.B.S.), Aarhus University Hospital; Danish Multiple Sclerosis Center (H.B.S.), Copenhagen University Hospital-Rigshospitalet, Glostrup; and Department of Clinical Immunology (A.C.N.), Odense University Hospital, Denmark.
ORCID: 0000-0002-0972-5222

Sören Möller (S)

From the Department of Neurology (V.P., Z.I.), Odense University Hospital, University of Southern Denmark; Danish Multiple Sclerosis Center and Danish Multiple Sclerosis Registry (M.M., F.S., J.L.B.), Copenhagen University Hospital-Rigshospitalet, Glostrup; Department of Clinical Medicine (M.M., F.S., J.L.B.), Faculty of Health and Medical Sciences, University of Copenhagen; Open Patient Data Explorative Network (S.M.), Odense University Hospital and Research Unit OPEN, Department of Clinical Research, University of Southern Denmark; Department of Neurology (K.B.S.), Aarhus University Hospital; Danish Multiple Sclerosis Center (H.B.S.), Copenhagen University Hospital-Rigshospitalet, Glostrup; and Department of Clinical Immunology (A.C.N.), Odense University Hospital, Denmark.
ORCID: 0000-0003-0858-4269

Finn Sellebjerg (F)

From the Department of Neurology (V.P., Z.I.), Odense University Hospital, University of Southern Denmark; Danish Multiple Sclerosis Center and Danish Multiple Sclerosis Registry (M.M., F.S., J.L.B.), Copenhagen University Hospital-Rigshospitalet, Glostrup; Department of Clinical Medicine (M.M., F.S., J.L.B.), Faculty of Health and Medical Sciences, University of Copenhagen; Open Patient Data Explorative Network (S.M.), Odense University Hospital and Research Unit OPEN, Department of Clinical Research, University of Southern Denmark; Department of Neurology (K.B.S.), Aarhus University Hospital; Danish Multiple Sclerosis Center (H.B.S.), Copenhagen University Hospital-Rigshospitalet, Glostrup; and Department of Clinical Immunology (A.C.N.), Odense University Hospital, Denmark.
ORCID: 0000-0002-1333-9623

Jette L Battistini (JL)

From the Department of Neurology (V.P., Z.I.), Odense University Hospital, University of Southern Denmark; Danish Multiple Sclerosis Center and Danish Multiple Sclerosis Registry (M.M., F.S., J.L.B.), Copenhagen University Hospital-Rigshospitalet, Glostrup; Department of Clinical Medicine (M.M., F.S., J.L.B.), Faculty of Health and Medical Sciences, University of Copenhagen; Open Patient Data Explorative Network (S.M.), Odense University Hospital and Research Unit OPEN, Department of Clinical Research, University of Southern Denmark; Department of Neurology (K.B.S.), Aarhus University Hospital; Danish Multiple Sclerosis Center (H.B.S.), Copenhagen University Hospital-Rigshospitalet, Glostrup; and Department of Clinical Immunology (A.C.N.), Odense University Hospital, Denmark.

Kristina B Svendsen (KB)

From the Department of Neurology (V.P., Z.I.), Odense University Hospital, University of Southern Denmark; Danish Multiple Sclerosis Center and Danish Multiple Sclerosis Registry (M.M., F.S., J.L.B.), Copenhagen University Hospital-Rigshospitalet, Glostrup; Department of Clinical Medicine (M.M., F.S., J.L.B.), Faculty of Health and Medical Sciences, University of Copenhagen; Open Patient Data Explorative Network (S.M.), Odense University Hospital and Research Unit OPEN, Department of Clinical Research, University of Southern Denmark; Department of Neurology (K.B.S.), Aarhus University Hospital; Danish Multiple Sclerosis Center (H.B.S.), Copenhagen University Hospital-Rigshospitalet, Glostrup; and Department of Clinical Immunology (A.C.N.), Odense University Hospital, Denmark.

Helle B Søndergaard (HB)

From the Department of Neurology (V.P., Z.I.), Odense University Hospital, University of Southern Denmark; Danish Multiple Sclerosis Center and Danish Multiple Sclerosis Registry (M.M., F.S., J.L.B.), Copenhagen University Hospital-Rigshospitalet, Glostrup; Department of Clinical Medicine (M.M., F.S., J.L.B.), Faculty of Health and Medical Sciences, University of Copenhagen; Open Patient Data Explorative Network (S.M.), Odense University Hospital and Research Unit OPEN, Department of Clinical Research, University of Southern Denmark; Department of Neurology (K.B.S.), Aarhus University Hospital; Danish Multiple Sclerosis Center (H.B.S.), Copenhagen University Hospital-Rigshospitalet, Glostrup; and Department of Clinical Immunology (A.C.N.), Odense University Hospital, Denmark.

Anna C Nilsson (AC)

From the Department of Neurology (V.P., Z.I.), Odense University Hospital, University of Southern Denmark; Danish Multiple Sclerosis Center and Danish Multiple Sclerosis Registry (M.M., F.S., J.L.B.), Copenhagen University Hospital-Rigshospitalet, Glostrup; Department of Clinical Medicine (M.M., F.S., J.L.B.), Faculty of Health and Medical Sciences, University of Copenhagen; Open Patient Data Explorative Network (S.M.), Odense University Hospital and Research Unit OPEN, Department of Clinical Research, University of Southern Denmark; Department of Neurology (K.B.S.), Aarhus University Hospital; Danish Multiple Sclerosis Center (H.B.S.), Copenhagen University Hospital-Rigshospitalet, Glostrup; and Department of Clinical Immunology (A.C.N.), Odense University Hospital, Denmark.

Zsolt Illes (Z)

From the Department of Neurology (V.P., Z.I.), Odense University Hospital, University of Southern Denmark; Danish Multiple Sclerosis Center and Danish Multiple Sclerosis Registry (M.M., F.S., J.L.B.), Copenhagen University Hospital-Rigshospitalet, Glostrup; Department of Clinical Medicine (M.M., F.S., J.L.B.), Faculty of Health and Medical Sciences, University of Copenhagen; Open Patient Data Explorative Network (S.M.), Odense University Hospital and Research Unit OPEN, Department of Clinical Research, University of Southern Denmark; Department of Neurology (K.B.S.), Aarhus University Hospital; Danish Multiple Sclerosis Center (H.B.S.), Copenhagen University Hospital-Rigshospitalet, Glostrup; and Department of Clinical Immunology (A.C.N.), Odense University Hospital, Denmark.
ORCID: 0000-0001-9655-0450

Classifications MeSH