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.
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Samadzadeh Sara, Oertel Frederike Cosima, Salih Hadi, Lin Ting-Yi, Motamedi Seyedamirhosein, Chien Claudia, Cook Lawrence J, Lana-Peixoto Marco Aurélio, Fontenelle Mariana Andrade, Kim Ho Jin, Hyun Jae-Won, Jung Su-Kyung, Palace Jaqueline, Roca-Fernandez Adriana, Leite Maria Isabel, Sharma Srilakshmi M, Ashtari Fereshteh, Kafieh Rahele, Dehghani Alireza, Pourazizi Mohsen, Pandit Lekha, Dcunha Anitha, Aktas Orhan, Ringelstein Marius, Albrecht Philipp, May Eugene F, Tongco Caryl, Leocani Letizia, Pisa Marco, Radaelli Marta, Sánchez-Dalmau Bernardo, Martinez-Lapiscina Elena H, Stiebel-Kalish Hadas, Hellmann Mark A, Lotan Itay, Siritho Sasitorn, de Seze Jérôme, Senger Thomas, Havla Joachim, Marignier Romain, Tilikete Caroline Froment, Cobo-Calvo Alvaro, Bichuetti Denis, Tavares Ivan Maynart, Soelberg Kerstin, Altintas Ayse, Yildirim Rengin, Tanriverdi Uygur, Jacob Anu, Huda Saif, Rimler Zoe, Reid Allyson, Mao-Draayer Yang, Villoslada Pablo, de Castillo Ibis Soto, Green Ari, Petzold Axel, Yeaman Michael R, Smith Terry J, Brandt Alexander U, Zimmermann Hanna G, Paul Friedemann, Asgari Nasrin, Guthy Jackson Charitable Foundation – International Clinical Consortium and CROCTINO Collaborators
Аннотация
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 < 0.001). OCT revealed reduced inner nuclear layer thickness in AQP4-NMOSD with comorbidities compared to non-comorbidity (B = -1.52, p = 0.047), more pronounced with CVC/RF (B = -2.96, p = 0.009).
CONCLUSION: Comorbidities are frequent in AQP4-NMOSD and MOGAD and are associated with ON frequency and disability. These findings highlight the need for proactive comorbidity management to improve patient care.