Investigating Disability and Onset Age in NMOSD: Gabrielle Macaron, MD


The neurologist from Cleveland Clinic discussed how her study reinforced previous findings that individuals with early onset neuromyelitis optica spectrum disorders are more likely to experience severe vision loss.

"The escalation approach is becoming less and less popular over time, especially in recent years, and the early high efficacy approach is gaining more popularity, because we know the consequences long term in multiple sclerosis (MS). I'm hoping we can do the same in neuromyelitis optica spectrum disorders (NMOSD).”

Researchers from Cleveland Clinic have found that patients with an age of onset (AO) of under 21 years of NMOSD were more likely to experience severe residual visual loss (SRVL) independent of disease duration.

These patients were more likely to have SRVL, as well as blindness, binocular optic neuritis (ON), and recurrent optic neuritis when compared to patients with AO greater than or equal to 21 years. However, they were less likely to receive high-efficacy first-line oral therapy. After adjusting for race, sex and disease disruption, the odds of SRVL were 4.68 times greater in patients with an AO <21 years (95% CI, 1.53–14.34; P = .007).

NeurologyLive reached out to first author Gabrielle Macaron, MD, neurologist, Cleveland Clinic and Hôtel-Dieu de France Hospital, Lebanon, to learn more about NMOSD about the associations between NMOSD AO and vision loss. Macaron stressed that more research needs to be done to understand the differences between NMOSD in younger and older populations and that traditional approaches to treating NMOSD should shift according to these and previously reported data. She also discussed recent medications such as eculizumab being studied in NMOSD.

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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