Comorbidities Are Associated With Unfavorable Outcome in Aquaporin-4 Antibody Positive Neuromyelitis Optica Spectrum Disorders and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: Exploratory Study From the CROCTINO Cohort.
Samadzadeh S., Oertel FC., Salih H., Lin T-Y., Motamedi S., Chien C., Cook LJ., Lana-Peixoto MA., Fontenelle MA., Kim HJ., Hyun J-W., Jung S-K., Palace J., Roca-Fernandez A., Leite MI., Sharma SM., Ashtari F., Kafieh R., Dehghani A., Pourazizi M., Pandit L., Dcunha A., Aktas O., Ringelstein M., Albrecht P., May EF., Tongco C., Leocani L., Pisa M., Radaelli M., Sánchez-Dalmau B., Martinez-Lapiscina EH., Stiebel-Kalish H., Hellmann MA., Lotan I., Siritho S., de Seze J., Senger T., Havla J., Marignier R., Tilikete CF., Cobo-Calvo A., Bichuetti D., Tavares IM., Soelberg K., Altintas A., Yildirim R., Tanriverdi U., Jacob A., Huda S., Rimler Z., Reid A., Mao-Draayer Y., Villoslada P., de Castillo IS., Green A., Petzold A., Yeaman MR., Smith TJ., Brandt AU., Zimmermann HG., Paul F., Asgari N., Guthy Jackson Charitable Foundation – International Clinical Consortium and CROCTINO Collaborators None.
BACKGROUND: Comorbidities occur in aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4-NMOSD), myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), and double seronegative NMOSD (DN-NMOSD), potentially contributing to a less favorable disease course. OBJECTIVES: To characterize comorbidities in AQP4-NMOSD, MOGAD, and DN-NMOSD and assess their association with optic neuritis (ON) outcomes by optical coherence tomography (OCT) in AQP4-NMOSD. METHODS: Four hundred and forty-two participants from the CROCTINO cohort were evaluated for comorbidities. RESULTS: In AQP4-NMOSD patients (n = 360), 43.5% (n = 161) had comorbidities, equally divided between single and multiple. In MOGAD (n = 49), 40.8% had comorbidities, with 75% (n = 15) single and 25% (n = 5) multiple. In DN-NMOSD (n = 33), 36.4% (n = 12) had comorbidities equally split. AQP4-NMOSD patients had more multiple comorbidities (50%, n = 81/161) than MOGAD (25%, n = 5/20, p = 0.03) and more autoimmune disorders (AID) (40.4%, n = 65) than MOGAD (20%, n = 4, p = 0.09) and DN-NMOSD (none, p = 0.004). Cardiovascular comorbidities and related risk factors (CVC/RF) occurred in 34.8% (n = 56) of AQP4-NMOSD, 50% (n = 10) of MOGAD, and 33.3% (n = 4) of DN-NMOSD. Expanded Disability Status Scale was higher in MOGAD (3.0 vs. 2.0, p = 0.006) and DN-NMOSD (5.0 vs. 2.0, p = 0.008) with comorbidities. AQP4-NMOSD patients with CVC/RF had higher ON relapse rates than those with AID (1.06 ± 3.33 vs. 0.49 ± 0.98, p