Influence of female sex and fertile age on neuromyelitis optica spectrum disorders

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Item Type:	Article
Title:	Influence of female sex and fertile age on neuromyelitis optica spectrum disorders
Creators Name:	Borisow, N., Kleiter, I., Gahlen, A., Fischer, K., Wernecke, K.D., Pache, F., Ruprecht, K., Havla, J., Krumbholz, M., Kümpfel, T., Aktas, O., Ringelstein, M., Geis, C., Kleinschnitz, C., Berthele, A., Hemmer, B., Angstwurm, K., Weissert, R., Stellmann, J.P., Schuster, S., Stangel, M., Lauda, F., Tumani, H., Mayer, C., Zeltner, L., Ziemann, U., Linker, R.A., Schwab, M., Marziniak, M., Then Bergh, F., Hofstadt-van Oy, U., Neuhaus, O., Winkelmann, A., Marouf, W., Rückriem, L., Faiss, J., Wildemann, B., Paul, F., Jarius, S., Trebst, C. and Hellwig, K.
Abstract:	BACKGROUND: Gender and age at onset are important epidemiological factors influencing prevalence, clinical presentation, and treatment response in autoimmune diseases. OBJECTIVE: To evaluate the impact of female sex and fertile age on aquaporin-4-antibody (AQP4-ab) status, attack localization, and response to attack treatment in patients with neuromyelitis optica (NMO) and its spectrum disorders (neuromyelitis optica spectrum disorder (NMOSD)). METHODS: Female-to-male ratios, diagnosis at last visit (NMO vs NMOSD), attack localization, attack treatment, and outcome were compared according to sex and age at disease or attack onset. RESULTS: A total of 186 NMO/SD patients (82% female) were included. In AQP4-ab-positive patients, female predominance was most pronounced during fertile age (female-to-male ratio 23:1). Female patients were more likely to be positive for AQP4-abs (92% vs 55%; p < 0.001). Interval between onset and diagnosis of NMO/SD was longer in women than in men (mean 54 vs 27 months; p = 0.023). In women, attacks occurring ⩽40 years of age were more likely to show complete remission (p = 0.003) and better response to high-dose intravenous steroids (p = 0.005) compared to woman at >40 years. CONCLUSION: Our data suggest an influence of sex and age on susceptibility to AQP4-ab-positive NMO/SD. Genetic and hormonal factors might contribute to pathophysiology of NMO/SD.
Keywords:	Neuromyelitis Optica, Sex, Age Factors, Aquaporin 4
Source:	Multiple Sclerosis Journal
ISSN:	1352-4585
Publisher:	Sage Publications
Volume:	23
Number:	8
Page Range:	1092-1103
Date:	July 2017
Official Publication:	https://doi.org/10.1177/1352458516671203
PubMed:	View item in PubMed

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