Contributions
Abstract: 210
Type: Scientific Session
Abstract Category: Clinical aspects of MS - Epidemiology
Introduction: The population-based epidemiology of neuromyelitis optica spectrum disorder (NMOSD) has not been evaluated in a Central/Eastern European country based on the current criteria.
Objectives: To estimate the prevalence and incidence of NMOSD in Hungary by applying the 2015 International Panel for NMO Diagnosis (IPND) criteria.
Methods: We conducted a retrospective population-based study covering 14 out the 19 Hungarian counties and Budapest with a population over 7 million. Patients (age≥16) were identified by employing multiple sources and multistage ascertainment. Patients suggestive for NMOSD from (I) hospitals health administrative databases using the International Classification of Diseases (optic neuritis-DH46.9, transverse myelitis-DG37.3 or neuromyelitis optica- DG36.0); (II) physician referrals; (III) requests from anti-aquaporin 4 antibody test were re-evaluated. Final case validation of potential diagnosis of NMOSD was performed by an expert board (AI, CR, KS, IZ).
Results: We idetified 154 NMOSD patients (age≥16) until 31.12.2016. All patients were Caucasian, 87.7% female and 83.1% seropositive. Fifty-sex percent of the cases met also Wingerchuk 2006 criteria for NMO. Median age at onset was 39.5 (range 7-83). Median follow-up was 7 years (range 0.08-41). The distribution of initial attack was 46.1% optic neuritis, 35% transverse myelitis, 7.1% brainstem syndrome, 2.6% area postrema, 1.3% ADEM-like syndrome and 7.7% combination of these. Initial brain MRI was normal in 52.1% and only 4.3% fulfilled Barkhof criteria. Spinal MRI revealed longitudinally extensive transverse myelitis in 83.3% of the cases. The prevalence analysis included 122 NMOSD living cases (108 women and 14 men) with onset before 2016. The included Hungarian population with age≥16 comprised 6,394,168 persons by 1. January 2016, resulting in a prevalence of 1.91 per 100,000 persons (95% CI; 1.58 - 2.28). We found 101 incident cases (88 women and 13 men) between 2006 and 2015 emerging from the entire background population observed for 76,766,609 person-years. Thus, the incidence rate was 0.132 per 100,000 person-years (95% CI; 0.107 - 0.160).
Conclusions: The population-based Hungarian prevalence and incidence of NMOSD is higher compared to previous studies in Caucasian populations. They are about twice as high compared to other recent studies applying similar study design and using 2015 IPND criteria on larger Caucasian predominant populations.
Disclosure: Papp V nothing to disclose. Illes Z is a member of clinical endpoint committees in clinical trials of NMOSD but it has no conflict of interest with the current study. Magyari M has served on scientific advisory board for Biogen, Sanofi, Teva, Roche, Novartis, Merck, has received honoraria for lecturing from Biogen, Merck, Novartis, Sanofi, Genzyme and support for congress participation from Biogen, Genzyme, Teva, Roche. Acs P nothing to disclose. Petersen T has received research support to the MS clinic at Aarhus University Hospital from Merck, Alexion, Roche, Biogen, Novartis, Sanofi. Iljicsov A has received honoraria for lecturing from Biogen, Merck, Teva and support for congress participation from Biogen, Genzyme, Merck, Teva. Rajda C has received support for congress invitation from Roche and Biogen, received honoraria for lecturing from Teva. Jakab G nothing to disclose. Deme I nothing to disclose. Nagy F nothing to disclose. Imre P nothing to disclose. Lohner Z nothing to disclose. Kovács K nothing to disclose. Jóri Birkás A nothing to disclose. Köves A nothing to disclose. Rum G nothing to disclose. Nagy Z nothing to disclose. Kerényi L has received support for congress participation from Genzyme. Jobbágy Z nothing to disclose. Diószeghy P nothing to disclose.
Horvath L has received support for congress participation from Biogen, Novartis, Genzyme, Teva, Roche. Galantai G (Vac) nothing to disclose. Kasza J nothing to disclose. Molnár G nothing to disclose. Sátori M nothing to disclose. Lovas G has served on scientific advisory board for Biogen, Sanofi, Roche, has received honoraria for lecturing from Biogen, Merck, Sanofi, Genzyme and support for congress participation from Biogen, Genzyme, Teva, Roche. Berki T nothing to disclose. Komoly S has served on scientific advisory board for Biogen, Sanofi, Teva, Roche, Novartis, Merck-Serono, has received honoraria for lecturing from Biogen, Merck, Novartis, Sanofi, Teva, Genzyme and support for congress participation from Biogen, Genzyme, Teva, Roche.
Abstract: 210
Type: Scientific Session
Abstract Category: Clinical aspects of MS - Epidemiology
Introduction: The population-based epidemiology of neuromyelitis optica spectrum disorder (NMOSD) has not been evaluated in a Central/Eastern European country based on the current criteria.
Objectives: To estimate the prevalence and incidence of NMOSD in Hungary by applying the 2015 International Panel for NMO Diagnosis (IPND) criteria.
Methods: We conducted a retrospective population-based study covering 14 out the 19 Hungarian counties and Budapest with a population over 7 million. Patients (age≥16) were identified by employing multiple sources and multistage ascertainment. Patients suggestive for NMOSD from (I) hospitals health administrative databases using the International Classification of Diseases (optic neuritis-DH46.9, transverse myelitis-DG37.3 or neuromyelitis optica- DG36.0); (II) physician referrals; (III) requests from anti-aquaporin 4 antibody test were re-evaluated. Final case validation of potential diagnosis of NMOSD was performed by an expert board (AI, CR, KS, IZ).
Results: We idetified 154 NMOSD patients (age≥16) until 31.12.2016. All patients were Caucasian, 87.7% female and 83.1% seropositive. Fifty-sex percent of the cases met also Wingerchuk 2006 criteria for NMO. Median age at onset was 39.5 (range 7-83). Median follow-up was 7 years (range 0.08-41). The distribution of initial attack was 46.1% optic neuritis, 35% transverse myelitis, 7.1% brainstem syndrome, 2.6% area postrema, 1.3% ADEM-like syndrome and 7.7% combination of these. Initial brain MRI was normal in 52.1% and only 4.3% fulfilled Barkhof criteria. Spinal MRI revealed longitudinally extensive transverse myelitis in 83.3% of the cases. The prevalence analysis included 122 NMOSD living cases (108 women and 14 men) with onset before 2016. The included Hungarian population with age≥16 comprised 6,394,168 persons by 1. January 2016, resulting in a prevalence of 1.91 per 100,000 persons (95% CI; 1.58 - 2.28). We found 101 incident cases (88 women and 13 men) between 2006 and 2015 emerging from the entire background population observed for 76,766,609 person-years. Thus, the incidence rate was 0.132 per 100,000 person-years (95% CI; 0.107 - 0.160).
Conclusions: The population-based Hungarian prevalence and incidence of NMOSD is higher compared to previous studies in Caucasian populations. They are about twice as high compared to other recent studies applying similar study design and using 2015 IPND criteria on larger Caucasian predominant populations.
Disclosure: Papp V nothing to disclose. Illes Z is a member of clinical endpoint committees in clinical trials of NMOSD but it has no conflict of interest with the current study. Magyari M has served on scientific advisory board for Biogen, Sanofi, Teva, Roche, Novartis, Merck, has received honoraria for lecturing from Biogen, Merck, Novartis, Sanofi, Genzyme and support for congress participation from Biogen, Genzyme, Teva, Roche. Acs P nothing to disclose. Petersen T has received research support to the MS clinic at Aarhus University Hospital from Merck, Alexion, Roche, Biogen, Novartis, Sanofi. Iljicsov A has received honoraria for lecturing from Biogen, Merck, Teva and support for congress participation from Biogen, Genzyme, Merck, Teva. Rajda C has received support for congress invitation from Roche and Biogen, received honoraria for lecturing from Teva. Jakab G nothing to disclose. Deme I nothing to disclose. Nagy F nothing to disclose. Imre P nothing to disclose. Lohner Z nothing to disclose. Kovács K nothing to disclose. Jóri Birkás A nothing to disclose. Köves A nothing to disclose. Rum G nothing to disclose. Nagy Z nothing to disclose. Kerényi L has received support for congress participation from Genzyme. Jobbágy Z nothing to disclose. Diószeghy P nothing to disclose.
Horvath L has received support for congress participation from Biogen, Novartis, Genzyme, Teva, Roche. Galantai G (Vac) nothing to disclose. Kasza J nothing to disclose. Molnár G nothing to disclose. Sátori M nothing to disclose. Lovas G has served on scientific advisory board for Biogen, Sanofi, Roche, has received honoraria for lecturing from Biogen, Merck, Sanofi, Genzyme and support for congress participation from Biogen, Genzyme, Teva, Roche. Berki T nothing to disclose. Komoly S has served on scientific advisory board for Biogen, Sanofi, Teva, Roche, Novartis, Merck-Serono, has received honoraria for lecturing from Biogen, Merck, Novartis, Sanofi, Teva, Genzyme and support for congress participation from Biogen, Genzyme, Teva, Roche.