Status of the neuromyelitis optica spectrum disorder in Latin America

• DOI: 10.1016/j.msard.2021.103083
• Publication Date: 2021-06-15T17:46:20Z
• Authors: Victor M. Rivera; Fernando Hamuy; Veronica Rivas; Fernando Gracia; Juan Ignacio Rojas; Denis Bernardi Bi...; Andres Maria Villa; Vanessa Daccah Ma...; Arnoldo Soto; Brenda Bertado; Irene Trevino Frenk; Lorna Galleguillos; Jairo Quiñones; Deyanira A. Ramirez; César Caparó-Zama...; Ethel Ciampi; Marco A. Lana-Pei...; Emmanuel Rodríguez; Luis Zarco; Vladimiro Sinay; Elizabeth Armas; Jefferson Becker; Aron Benzadón; Ericka Lopez; Edgar Carnero Con...; Edgar Patricio Co...; Alejandro Diaz; Cynthia Veronica ...; Gil Playas; Omaira Molina; Edgard Rojas; Douglas Sato; Ibis Soto; Johana Vásquez Cé...; Jorge Correale; Andres Barboza; Priscilla Monterrey; Awilda Candelario; Dario R. Tavolini; Alexander Parajeles; Biany Santos Pujol; Amado Diaz de la Fe; Ricardo Alonso; Carlos Bolaña; Marianne Kagi Guzman; Adriana Carrá; Oscar Gonzalez Ga...; Jose Vera Raggio; Luis Cesar Rodriguez; Nicia Eunice Ramirez; Laura Ordoñez; Eli Skromne; Ligia lbeth Portillo; Alfredo Perez Can...; Roberto Weiser; Vanessa Sirias; Ramiro Fernández ...; Ernesto Arturo Co...; Marianella Hernández; Juan Carlos Duran...; Luis Alberto Garcia; Carlos Oviedo Cedeño; Jorge Martínez; Patricio Abad-Her...
• Keywords: Neuromyelitis Optica; Optic neuritis

BackgroundNeuromyelitis optica spectrum disorders (NMOSD) is an increasing diagnostic and therapeutic challenge in Latin America (LATAM). Despite the heterogeneity of this population, ethnic socioeconomic commonalities exist, epidemiologic studies from region have had a limited geographic population outreach. Identification some aspects entire are lacking.ObjectivesTo determine ethnic, clinical characteristics, utilization tools types therapy for patients with NMOSD American region.MethodsThe Committee Treatment Research MS (LACTRIMS) created exploratory investigational survey addressed by Invitation to experts identified through diverse sources. Data input closed after 30 days initial invitation. The questionnaire allowed use absolute numbers or percentages. Multiple option responses covering 25 themes included definition type practice; number cases; ethnicity; 2015 International Panel criteria diagnosis Neuromyelitis (IPDN); phenotypes; methodology utilized determination anti-Aquaporin-4 (anti­ AQP4) antibodies serological testing, if was performed locally processed abroad; treatment relapses, long-term management were surveyed.ResultsWe 62 investigators 21 countries reporting information 2154 (utilizing IPDN 93.9% cases), which categorized two geographical regions: North-Central, including Caribbean (NCC), South (SA). Ethnic identification disclosed Mestizos 61.4% as main group. most common presenting symptoms concomitant presence optic neuritis transverse myelitis 31.8% (p=0.95); only 31.4% (more SA), p<0.001); involvement area postrema occurred 21.5% brain stem 8.3%, both more frequent cases (p<0.001). Anti-AQP4 positive 63.9% anti-Myelin Oligodendrocyte Glycoprotein (MOG) 4.8% total cases. specific laboratorial method employed not known 23.8% investigators. Acute relapses 81.6% cases, treated them intravenous steroids (IVS); 62.1% plasma exchange (PE), 40.9% immunoglobulin-G (IVIG). Therapy escalated due suboptimal response. Respondents favored Rituximab (86.3%), whereas azathioprine also on 81.8% either agent used indistinctly according accessibility judgement. There no differences among regions.ConclusionsThis first study all LATAM largest cohort reported multinational world area. distributions phenotypic features disease region, challenges access identified. neurological community should play determinant role encouraging advising local institutions health officials availability sensitive modern methodology, facilitating licensed medications NMOSD, addressing concerns education, community.