Abstract Details

Title Radiologic Disease Activity Independent of Relapses in Aquaporin4-IgG-Seropositive Neuromyelitis Optica Spectrum Disorder (AQP4-IgG+ NMOSD), MOGAD, and MS: A Retrospective Comparative Study

Topic Autoimmune Neurology

Presentation(s) S50 - Autoimmune Neurology: NMOSD (5:18 PM-5:30 PM)

Poster/Presentation
Number 010

Background

Relapse-independent radiologic disease activity is not well established in AQP4-IgG+NMOSD and MOGAD.

Objective

To investigate radiologic disease activity independent of relapses in patients with AQP4-IgG+NMOSD, MOGAD, and MS.

Design/Methods

This is a retrospective chart review study of AQP4-IgG+NMOSD and MOGAD patients from the neuroimmunology clinic of Massachusetts General Hospital, and equivalent MS controls matched for age, sex, and disease duration from the CLIMB study, Brigham and Women’s Hospital. All patients fulfilled the latest diagnostic criteria for each disease and had positive AQP4-IgG and MOG-IgG being tested by cell-based assays. We reviewed the MRI reports of the brain and spinal cord for new T2 lesions, new enhancing lesions, and persistent enhancement during relapse-free periods.

Results

We included 49 AQP4-IgG+NMOSD (89.9% female, mean follow-up (SD) of 43.5(19.0) months), 36 MOGAD (63.9% female, mean follow-up (SD) of 29.6(11.6) months), and equivalent 49 and 36 matched MS controls for each group. New T2 lesions in the brain MRI were seen in 6/49 (12.24%) AQP4-IgG+NMOSD and 20/49 (40.81%) MS controls (P value=0.001), as well as 1/36 (2.77%) MOGAD and 12/36 (33.33%) MS controls (P value= 0.001). New enhancing lesions in the brain MRI of AQP4-IgG+NMOSD and MS controls were seen in 1/49 (2.04%) and 14/49 (28.57%) (P value=0.000), as well as in 0/36 (0%) MOGAD and 13/36 (36.11%) MS controls (P=0.003). New T2 lesions in the spinal cord MRI were seen in 1/49 (2.04%) AQP4-IgG+NMOSD and 16/49 (32.65%) MS controls (P value=0.000), as well as 2/36 (5.55%) MOGAD and 11/36 (30.55%) MS controls (P value=0.006). Persistent enhancement was seen in brain and spinal cord MRIs of neither AQP4-IgG+NMOSD nor MOGAD patients but in 7/85 MS controls.

Conclusions

Relapse-independent new T2 or enhancing lesions in the brain and spinal cord are not common in AQP4-IgG+NMOSD and MOGAD patients, compared to MS.

Authors/Disclosures
Negar Molazadeh, MD PRESENTER	The institution of Dr. Molazadeh has received research support from Genentech, Inc..
Gauruv Bose, MD (The University of Ottawa and Ottawa Hospital Research Institute)	Dr. Bose has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Bose has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Bose has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva Pharmaceuticals. The institution of Dr. Bose has received research support from Multiple Sclerosis Society of Canada.
Tanuja Chitnis, MD, FAAN (Brigham and Women's Hospital)	Dr. Chitnis has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Chitnis has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche-Genentech. Dr. Chitnis has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Siemens. Dr. Chitnis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Octave Biosciences. Dr. Chitnis has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Academic CME. The institution of Dr. Chitnis has received research support from Novartis. The institution of Dr. Chitnis has received research support from Sanofi. The institution of Dr. Chitnis has received research support from Octave. The institution of Dr. Chitnis has received research support from Genentech-Roche.
Michael Levy, MD, PhD, FAAN (Massachusetts General Hospital/Harvard Medical School)	Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Pharma. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB Pharma. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Levy has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various law firms. The institution of Dr. Levy has received research support from National Institutes Health.