Epidemiology of neuromyelitis optica spectrum disease in Central-West Brazil: Prevalence and associated clinical and demographic features.

BACKGROUND

Neuromyelitis optica spectrum diseases (NMOSD) are rare autoimmune diseases of the central nervous system. Although Brazil reports one of the highest global prevalences of NMOSD, regional data, particularly from the Central-West, remain limited.

OBJECTIVES

To characterize the epidemiological, laboratory, and therapeutic profiles of NMOSD patients residing in Brazil's Federal District, based on 2015 international diagnostic criteria.

METHODS

This prospective observational study analyzed data from 55 consecutive NMOSD patients entered as new records in the Brazilian Registry of Neurological Diseases (REDONE.br) between July 2023 and July 2025. Statistical analyses included descriptive methods, between-group comparisons, and multivariable logistic-regression.

RESULTS

The cohort comprised 45 women (81.8%), with a mean age of onset of 36.85 ± 14.89 years. Myelitis was the most frequent initial presentation (76.4%), followed by unilateral optic neuritis (45.5%). The socioeconomic profile revealed marked vulnerability: 65.5% reported family income ≤2 minimum wages, and 45.5% were unemployed. Rituximab was the most frequently used disease-modifying therapy. The estimated NMOSD prevalence was 1.84 cases per 100,000 inhabitants (95% CI: 1.38-2.39), and the prevalence of antiAQP4 +  was 1.64 cases per 100,000 (95% CI: 1.21-2.16).

CONCLUSIONS

This study provides a comprehensive characterization of NMOSD in Brazil's Central-West region and highlights that the disease disproportionately affects individuals living in conditions of social vulnerability.