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The prevalence of neuromyelitis optica spectrum disorder (NMOSD) is higher in racial minority groups than in white populations, with varying disease manifestations and severity. Moreover, limited data suggest that NMOSD has an earlier age of onset and tends to have worse outcomes in racial minorities.

This retrospective study, published in Neurology, sought to address doubts and uncertainties surrounding NMOSD outcomes in different racial groups, including African Americans, African Europeans, Caucasians, and Asians. The study included 603 subjects with aquaporin-4 (AQP4) antibody–seropositive NMOSD from six different neurology departments across the globe. The study participants were assessed for age, ethnicity, disease manifestation at onset, symptomatic attacks, treatment selection, and other factors. 

Ultimately, it was found that Asian, African American, and African European participants experienced disease onset at a significantly younger age. In addition, Asian, African American, and African European patients exhibited significantly more brain or brainstem involvement at onset than Caucasians. African American and African European patients also exhibited significantly more severe attacks at onset than Asians and Caucasians. 

The researchers concluded that race might be a valid indicator of potential NMOSD activity and severity, and it is especially important to treat the disease early and effectively in racial minority groups. In particular, Asian, African American, and African European patients may require adjustments in immunosuppressive therapy to effectively treat their NMOSD and prevent worsening disability [1].


[1] Kim, S. H., Mealy, M. A., Levy, M., Schmidt, F., Ruprecht, K., Paul, F., Ringelstein, M., Aktas, O., Hartung, H. P., Asgari, N., Tsz-Ching, J. L., Siritho, S., Prayoonwiwat, N., Shin, H. J., Hyun, J. W., Han, M., Leite, M. I., Palace, J., & Kim, H. J. (2018). Racial differences in neuromyelitis optica spectrum disorder. Neurology, 91(22), e2089–e2099. https://doi.org/10.1212/wnl.0000000000006574

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