Improving Outcomes in Patients With Early Onset NMOSD: Gabrielle Macaron, MD


The neurologist from Cleveland Clinic discussed how her team found that patients with AO ≤21 years old had worse visual outcomes than those >21 years old.

“Younger individuals have worse visual outcomes... for this reason, maybe we should treat them with the efficacious medications early on in the disease course. We need more data to make sure that higher efficacy meds are safe in this population. We should start thinking about treating those patients more actively and early on, without using an escalation approach, which is what we traditionally do in multiple sclerosis.”

Data from a recent study suggest that patients with an age of onset (AO) of under 21 years with neuromyelitis spectrum disorders (NMOSD) were more likely to experiences severe residual visual loss (SRVL) independent of disease duration.

First author Gabrielle Macaron, MD, neurologist, Cleveland Clinic and Hôtel-Dieu de France Hospital, Lebanon, and colleagues found that patients with an AO of under 21 years of age were more likely to have SRVL, as well as blindness, binocular optic neuritis (ON), and recurrent optic neuritis when compared to patients with AO ≥21 years. These patients were also more likely to receive less effective first-line oral therapy. The odds of SRVL were 4.68 times greater in patients with an AO <21 years (95% CI, 1.53–14.34; P = .007) after adjusting for race, sex and disease disruption.

NeurologyLive reached out to Macaron to learn more about NMOSD and its available therapies. She discussed what steps should be taken next to help reduce debilitating attacks of NMOSD in younger patients.

Macaron G, Khoury J, Bena J, et al. Early age of onset predicts severity of visual impairment in patients with neuromyelitis optica spectrum disorder. Mult Scler J. Published online January 6, 2021. doi: 10.1177/1352458520981736
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