Produção Nacional
Clinical outcomes and prognostic factors in patients with optic neuritis related to NMOSD and MOGAD in distinct ethnic groups from Latin America
2023; Elsevier BV; Volume: 72; Linguagem: Inglês
10.1016/j.msard.2023.104611
ISSN2211-0356
AutoresEdgar Carnero Contentti, Pablo A. López, Juan Criniti, Juan Pablo Pettinicchi, Edgardo Cristiano, Liliana Patrucco, Elisa Bribiesca Contreras, Enrique Gómez‐Figueroa, José Flores‐Rivera, Edgar Patricio Correa‐Díaz, Ana María Toral Granda, Maria Yepez, Wilson Alfredo Gualotuña Pachacama, Jefferson Santiago Piedra Andrade, Lorna Galleguillos, Verónica Tkachuk, Débora Nadur, Vanessa Daccach Marques, Ibis Soto de Castillo, Magdalena Casas, Leila Cohen, Ricardo Alonso, Alejandro Caride, Marco Aurélio Lana–Peixoto, Juan Ignacio Rojas,
Tópico(s)Systemic Lupus Erythematosus Research
ResumoBackground Optic neuritis (ON) can be an initial manifestation of neuromyelitis optica spectrum disorder (NMOSD) associated with aquaporin 4-antibody (AQP4-Ab) or myelin oligodendrocyte glycoprotein antibody (MOG-Ab)-associated disease (MOGAD). Additionally, both diseases may have overlapping paraclinical and radiological features. These diseases may have different outcomes and prognoses. We aimed to compare clinical outcomes and prognostic features of patients with NMOSD and MOGAD presenting ON as first attack, from different ethnic groups in Latin America. Methods We conducted a retrospective observational multicenter study in patients from Argentina (n = 61), Chile (n = 18), Ecuador (n = 27), Brazil (n = 30), Venezuela (n = 10) and Mexico (n = 49) with MOGAD or NMOSD related ON. Predictors of disability outcomes at last follow-up, namely visual disability (Visual Functional System Score ≥4), motor disability (permanent inability to walk further than 100 m unaided) and wheelchair dependence based on EDSS score were evaluated. Results After a mean disease duration of 42.7 (±40.2) months in NMOSD and 19.7 (±23.6) in MOGAD, 55% and 22% (p>0.001) experienced permanent severe visual disability (visual acuity from 20/100 to 20/200), 22% and 6% (p = 0.01) permanent motor disability and 11% and 0% (p = 0.04) had become wheelchair dependent, respectively. Older age at disease onset was a predictor of severe visual disability (OR=1,03 CI95%1.01–1.05, p = 0.03); older age at disease onset (OR=1,04 CI95%1.01–1.07, p = 0.01), higher number of relapses (OR=1,32 CI95%1.02–1.71, p = 0.03) and rituximab treatment (OR=0,36 CI95%0.14–0.90, p = 0.02) were predictors of permanent motor disability, whereas ON associated with myelitis at disease onset was a predictor of wheelchair dependency (OR=4,16, CI95%1.23–14.08, p = 0,02) in NMOSD patients. No differences were found when evaluating distinct ethnic groups (Mixed vs. Caucasian vs. Afro-descendant) Conclusions NMOSD was associated with poorer clinical outcomes than MOGAD. Ethnicity was not associated with prognostic factors. Distinct predictors of permanent visual and motor disability and wheelchair dependency in NMOSD patients were found.
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