Evaluation of Comorbidities and Health Care Resource Use Among Patients with Highly Active Neuromyelitis Optica
Ajmera MR, Boscoe A, Mauskopf J, Candrilli SD, Levy M
Neuromyelitis optica is a potentially life-threatening, autoimmune disease of the central nervous system. It affects the optic nerves and spinal cord, can cause a variety of symptoms, and can eventually cause blindness, or paralysis. There currently is no approved treatment for this disease. Corticosteroids and plasma exchanges are used for acute relapses, and immunosuppressant therapies are used for relapse prevention.
Patients who have frequent relapses generally have a poor prognosis. To better understand the medical burden of NMO, we assessed comorbidities and event-driven health care resource use among patients with highly active NMO.
To our knowledge, this is the first study to examine resource use and the prevalence of comorbidity using real-world data.
Out of 1,349 patients who met the study eligibility criteria, about 10% had highly-active NMO. A 1:5 case-control matching using propensity score technique was performed to identify controls for the highly-active NMO patients.
Comorbidity burden was significantly greater among patients with highly active NMO compared with controls. Hypertension was the most prevalent comorbidity, followed by hemiplegia, and bladder dysfunction. Certain conditions that can be linked to increased inflammation and autoantibody production were more prevalent among patients with NMO compared to controls. In addition, NMO patients were fives time more likely to have depression as well, possibly because of anxiety and stress due to relapses.
Patients with highly active NMO had more than 10 times the number of hospitalizations during the study follow-up period, and their average length of stay was significantly longer than the matched control patients.
This study illustrates the need for effective new therapies to reduce the risk of relapses and minimize the comorbidity burden of patients with highly active NMO.
This research has been published in the Journal of the Neurological Sciences.