A study on patients with neuromyelitis optica spectrum disorder from Eastern India

Abstract

BackgroundTo study the clinical presentation and response to immunosuppressives in patients with Neuromyelitis Optica Spectrum Disorder (NMOSD) in a tertiary care hospital of eastern India. ResultsThere was a female preponderance of the disease (6.5:1) with mean age of disease onset 26.6 years. Isolated ON was the most common presentation at disease onset (60 %). Among motor symptoms at disease onset, only quadriparesis predicted a worse EDSS outcome at last follow up (p = 0.003). Visual acuity ≤6/60 and bilateral involvement was more common in the seropositive patients than in seronegative patients. Anti MOG Antibody was tested in 64.2 % of seronegative patients and was negative. Rituximab was most effective in preventing relapses (no relapses) followed by azathioprine (reduction of ARR of 90.1 %) and mycophenolate (reduction of ARR of 58.6 %). Also the reduction in median EDSS score and median FSS score for vision was greatest for the patients who received rituximab (52.9 % and 33.3 % respectively). ConclusionRelapsing course of the disease was frequently observed with isolated optic neuritis being the most common symptom at disease onset. Among the motor features only quadriparesis at disease onset predicted a worse disease outcome. Rituximab was most effective in reducing the median EDSS score on follow up and preventing relapse.