Speakers - NWC 2024

Abstract

Abstract: Central Nervous System Inflammatory Demyelinating Disease (CNS- IDD) is a chronic immune-mediated condition requiring long-term patient monitoring and follow-up. The most common CNS-IDDs are Multiple sclerosis (MS), Neuromyelitis Optica Spectrum Disorder (NMOSD), and Myelin Oligodendrocyte Glycoprotein Antibody Associated Disease (MOGAD). A dedicated database was maintained at our Institute, enabling us to gain insight into our patients' disease profiles and outcomes. In addition, this database will allow us to plan research initiatives in various domains of pathophysiology, management, and rehabilitation. We aimed to study the Demographic & Treatment profile of CNS-IDD.

Methodology: Prospective study of patients attending Neurology services at a tertiary University hospital in Southern India.

Results: We enrolled 200 patients with CNS-IDD from February 2022 to August 2022 (7 months). The mean age of patients was 32.0±11.4 years (2.6 - Female: Male). Multiple Sclerosis (MS) was diagnosed in 103 patients; 33 had AQP4+ve NMOSD, 24 had MOGAD, and 40 patients had other CNS-IDD. Among the MS patients, 91 were relapsing-remitting; nine were secondary progressive, and 3 were primary progressive type. The mean age of onset of symptoms was 26.3±12 years. The mean duration between onset of illness and diagnosis was 5.5 years (Median: 3.5 years). The initial presentation was spinal cord involvement (39.5%), followed by the optic nerve (31%), and 14% had brainstem manifestations. The average number of relapses during the disease course was 3.1 (range:0-9). Among the MS patients, the disease-modifying agents (DMAs) administered were Rituximab (86), dimethyl fumarate (39), natalizumab (11), & other DMAs (41). Among the AQP4+ve NMOSD and MOGAD patients, 75.75% and 50% received rituximab, respectively, whereas mycophenolate mofetil and azathioprine were the other immunomodulators.

Conclusions: Maintaining a dedicated clinical database provides a unique opportunity to study CNS demyelinating disorders' clinical features and phenotypes and optimize outcomes in patient care and management.