The Analysis of Association Between the Disability and Multiple Autoantibodies in Neuromyelitis Optica Spectrum Disorder (NMOSD)

Abstract

Objective: We investigated the prevalence of various autoantibodies and the associations between the existence of autoantibodies and disability in Neuromyelitis optica spectrum disorder (NMOSD) patients, using the data from web-based nationwide clinical registry of NMOSD in Korea.

Background: NMOSD was rare neuroinflammatory disease, often coexists with autoantibodies such as anti-nucleotide antibody (ANA) or anti-Sjogren’s syndrome A antibody (SSA). However, the relationship between autoantibodies and NMOSD is not clear.

Design/Methods: We collected the clinical information and the autoantibodies profile including ANA, SSA, anti-Sjogren’s syndrome B antibody (SSB), anti-neutrophil cytoplasmic antibody (ANCA), anti-thyroperoxidase antibody (TPO), anti-thyroglobulin antibody (TG), anti-doublestrand DNA antibody (ds DNA), anti-cardiolipine antidbody and rheumatoid factor (RF) in NMOSD patients of 11 hospitals in Korea for 3 years (2014. Sep – 2016. Nov), using internet-based clinical research and trial management system (iCReaT). We evaluated the associations between the seropositivity of each autoantibodies and the time from onset of NMOSD to the point to reach the higher Expanded Disability Status Scale (EDSS) score (EDSS>6.0) using cox-regression survival analysis.

Results: Among the included 158 patients, the female was about 93%, the median of EDSS was 3 (IQR 2–4), and the mean of disease duration from onset was 8.2 (SD 6.5) years. The frequency of autoantibodies was ANA (31.6%), SSA (27.2%), SSB (9.5%), RF (7.5%), TPO (6.3%), dsDNA (5.7%), TG (5.1%), lupus anticoagulant antibody (4.6%), anti-cardiolipine antibody (4.5%), and ANCA (1.9%). Higher EDSS was associated the elevation of RF (p=0.03, HR=6.1(95% CI 1.76–21.74)) and other antibodies were not showed association with higher EDSS in statics. Additionally, the age of initial attack was related to higher disability in NMOSD patients (p=0.002, HR=1.07(95% CI 1.02–1.11)).

Conclusions: We confirmed that various autoantibodies were presented and suggested that the elevation of RF may be associated the higher disabilities in NMOSD patients. Old age might be slightly elevated the risk of higher disability.