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Abstract Details

Predicting Functional Outcome and Response to Therapy of Anti-NMDAR Encephalitis, Already at Diagnosis: The NEOS2 Model.
Autoimmune Neurology
P5 - Poster Session 5 (11:45 AM-12:45 PM)
6-009
Anti-NMDARE is a severe, but treatable neurological condition, with considerable and variable long-term disability. The available NEOS score predicts outcome a month into treatment. To predict outcome and response to immunotherapy at the time of diagnosis would be a big improvement. This would timely identify patients needing aggressive treatment and avoid harmful side-effects in those with good outcome.

Develop and validate a model to predict functional outcome and response to first-line therapy at the time of diagnosis of anti-NMDAR encephalitis (anti-NMDARE).

Data of five anti-NMDARE cohorts (the Netherlands, Germany [GENERATE], France, Spain and Japan) were combined. The datasets per country will be randomly split for development (70%) and validation (30%).

The primary outcome is functioning at one year, measured by the modified Rankin Scale (mRS). Secondary outcomes are effect of first-line therapy and ability to go back to work or school.

We have performed preliminary logistic regression analyses.

We have included 720 patients (79% female; mean age 25 years, 95% Confidence-Interval [CI] 2-67 years). 79% of patients had good functionality after one year, 74% was able to return to work/school. In univariable analysis, twelve predictive variables for functional outcome were identified. In a preliminary multivariable analysis, five independent predictive variables remained significant: age at disease onset, diagnostic delay, dysautonomia, ICU admission and CSF leukocyte count. A very preliminary five-point model, accurately classifies patients into outcome categories (97% good outcome if 0 points to 27% if 5 points). The model also seems to predict response to first-line therapy (from 87% response if 0 points to 27% if 5 points). We are currently improving the model.

In anti-NMDAR encephalitis, outcome at one year and response to first-line therapy can already be predicted at the time of diagnosis.

Authors/Disclosures
Juliette Brenner, MD (Erasmus University Medical Center)
PRESENTER
Ms. Brenner has nothing to disclose.
Anna Bastiaansen Anna Bastiaansen has nothing to disclose.
Marlieke De Bruijn No disclosure on file
Frank Leypoldt, MD (University Hospital Schleswig-Holstein, Campus Kiel Department of Neurology) Frank Leypoldt, MD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Frank Leypoldt, MD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Frank Leypoldt, MD has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. The institution of Frank Leypoldt, MD has received research support from German Ministry of Education and Science . The institution of Frank Leypoldt, MD has received research support from German Research Council.
Jerome Honnorat, MD, PhD (Hospices Civils de Lyon) The institution of Jerome Honnorat, MD, PhD has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for journal of neurology.
Josep O. Dalmau, MD, PhD, FAAN Dr. Dalmau has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astellas Research Institute of America. Dr. Dalmau has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen Research & Development . Dr. Dalmau has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Academy of Neurology. An immediate family member of Dr. Dalmau has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Dalmau has received research support from Sage Therapeutics. The institution of Dr. Dalmau has received research support from Edmond J.Safra Foundation . The institution of Dr. Dalmau has received research support from La Caixa Foundation. The institution of Dr. Dalmau has received research support from Spanish Ministry of Health (ISCIII). The institution of Dr. Dalmau has received research support from Euroimmun, Inc. Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. An immediate family member of Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. An immediate family member of Dr. Dalmau has received intellectual property interests from a discovery or technology relating to health care. Dr. Dalmau has received publishing royalties from a publication relating to health care. Dr. Dalmau has received publishing royalties from a publication relating to health care. Dr. Dalmau has received publishing royalties from a publication relating to health care.
Takahiro Iizuka, MD (Department of Neurology, Kitasato University School of Medicine) The institution of Dr. Iizuka has received research support from Astellas Pharma Inc.
Mareike Jansen, Other Miss Jansen has nothing to disclose.
Ina Schroder No disclosure on file
Sergio Muniz-Castrillo, MD, PhD (Stanford university) Dr. Muniz-Castrillo has nothing to disclose.
Yvette Crijnen, MD Ms. Crijnen has nothing to disclose.
Juna Marcella De Vries, MD,PhD (Erasmus MC) The institution of Dr. De Vries has received research support from 2021 AEA Community Seed Grant.
Marco Schreurs Marco Schreurs has nothing to disclose.
Amaia Munoz Amaia Munoz has nothing to disclose.
Mar Guasp, MD (Hospital Clínic Barcelona - IDIBAPS) Dr. Guasp has nothing to disclose.
Peter Sillevis Smitt, MD (Erasmus MC) The institution of Dr. Sillevis Smitt has received research support from Euroimmun. Dr. Sillevis Smitt has received intellectual property interests from a discovery or technology relating to health care.
Maarten Jan Titulaer, MD, PhD (Erasmus Medical Center) The institution of Dr. Titulaer has received research support from Dutch Epilepsy Foundations (NEF 19-08). The institution of Dr. Titulaer has received research support from CSL Behring. The institution of Dr. Titulaer has received research support from UCB. The institution of Dr. Titulaer has received research support from Netherlands Organisation for Scientific Research (ZonMW, Memorabel initiative and E-RARE UltraAIE) . The institution of Dr. Titulaer has received research support from Horizon Therapeutics. The institution of Dr. Titulaer has received research support from Dioraphte (charity). The institution of Dr. Titulaer has received research support from Guidepoint Global LLC. The institution of Dr. Titulaer has received research support from UpToDate Inc.