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Abstract Details

Racial and Ethnic Disparities in the Incidence of Neuromyelitis Optica Spectrum Disorder
General Neurology
P4 - Poster Session 4 (11:45 AM-12:45 PM)
Ecological comparisons have suggested that the NMOSD incidence may be higher in African and Asian countries, but no studies have examined racial/ethnic differences within the same population.
To determine the incidence of Neuromyelitis Optica Spectrum Disorder (NMOSD) in a large, contemporary, multi-ethnic cohort.
We conducted a retrospective cohort study among the multi-ethnic members of Kaiser Permanente Southern California, 2010-2021. The complete electronic health records of individuals with ≥1 NMOSD ICD code were reviewed to identify patients who met the 2015 NMOSD diagnostic criteria. Crude and age and sex-standardized incidences stratified by race and ethnicity were estimated according to the 2020 US Census population.

We identified 127 newly diagnosed NMOSD patients of whom 89.0% were aquaporin-4 antibody positive. The median age at diagnosis was 46.6 years (IQR 32.7-57.6, range 6.0-84.9) and 110 (86.6%) were females. The female preponderance was more pronounced in Asian (95.2%), Hispanic (90.5%) and Black persons (89.7%) than White individuals (68.0%) The age- and sex-standardized incidence of NMOSD per 1 million person-years was significantly higher in Black persons (9.21, 95%CI 6.27–12.15) compared to all other racial/ethnic groups. The incidence in Asian persons (3.77, 95%CI 2.15–5.40) was higher than Hispanic (2.02, 95%CI 1.41–2.63) or White, non-Hispanic persons (1.56, 95%CI 0.95–2.18) whose rates were similar.  Black persons had a higher NMOSD incidence across all age strata compared to other groups except 65 and older where the incidence was similar across all racial and ethnic groups.

In this large, contemporary cohort, we found that NMOSD is a female-predominant disease that disproportionately affects Black and, to a lesser extent, Asian persons. Although NMOSD incidence is much lower, its pattern is more like systemic lupus erythematosus than multiple sclerosis. 
Angus Lee, DO (Kaiser Permanente Los Angeles Medical Center)
Dr. Lee has nothing to disclose.
Jessica B. Smith, MPH (Kaiser Permanente) Ms. Smith has nothing to disclose.
Bonnie Li No disclosure on file
Radostina Iordanova, DO (Kaiser Permanente Los Angeles Medical Center) Dr. Iordanova has nothing to disclose.
Annette M. Langer-Gould, MD, PhD (Kaiser Permanente Southern California) An immediate family member of Dr. Langer-Gould 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 Annals of American Thoracic Society. The institution of Dr. Langer-Gould has received research support from PCORI. The institution of an immediate family member of Dr. Langer-Gould has received research support from PCORI, ARQ, NIH. Dr. Langer-Gould has a non-compensated relationship as a Voting Member with ICER CTAF Panel that is relevant to AAN interests or activities.