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Publications

Journal Article Ppublish

PubMed: 42172556 DOI: 10.1212/WNL.0000000000218073

French NOMADMUS Cohort Overview: Landscape Evolution of AQP4+NMOSD and MOGAD From 2010 to 2024.

Neurology 106(12):e218073

Authors: Thomas Roux, François-Xavier Lejeune, Romain Casey, Bertrand Audoin, Xavier Ayrignac, Bertrand Bourre, Jonathan Ciron, Mikael Cohen, Nicolas Collongues, Francois Cotton, Kumaran Deiva, Romain Deschamps, Françoise Durand-Dubief, David Axel Laplaud, Laure Michel, Caroline Papeix, Julie Pique, Aurélie Ruet, Eric Thouvenot, Helene Zephir, Valerie Touitou, Sandra Vukusic, Bruno Stankoff, Lakhdar Benyahya, Romain Marignier, Elisabeth Maillart

Affiliations

  • Department of Neurology, centre de ressources et de compétences SEP-Paris, Pitié-Salpêtrière University Hospital, AP-HP, 47, boulevard de l'Hôpital, France.
  • Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle (MIRCEM).
  • Paris-Brain Institute (ICM), Paris Brain Institute's Data and Analysis Core, Pitié-Salpêtrière hospital, Sorbonne université, Inserm U1127, CNRS UMR 7225, France.
  • Université de Lyon, Université Claude Bernard Lyon 1, France.
  • Hospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, Bron, France.
  • Observatoire Français de la Sclérose en Plaques, Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292, Lyon, France.
  • EUGENE DEVIC EDMUS Foundation against multiple sclerosis, state-approved foundation, Bron, France.
  • Marseille University Hospital Timone, Neurology, France.
  • Montpellier University Hospital, Neurology, France.
  • Department of Neurology, CHU ROUEN, France.
  • Department of Neurology, University Hospital of Toulouse, CRC-SEP, France.
  • University Toulouse III, Infinity, INSERM UMR1291-CNRS UMR5051, France.
  • CRCSEP Neurologie Pasteur 2, CHU de Nice, Université Cote d'Azur, UMR2CA (URRIS), Nice, France.
  • CHU Strasbourg, Neurology and CIC 1434, France.
  • Hospices Civils de Lyon-CH Lyon Sud, Radiology, France.
  • INSA-Lyon, Universite Claude Bernard Lyon 1, CNRS, Inserm, CREATIS UMR 5220, U1294, France.
  • Department of Paediatric Neurology, Assistance Publique-Hôpitaux de Paris, University Hospital Paris Saclay, Bicêtre Hospital, Le Kremlin-Bicêtre, France.
  • Rothschild Foundation Hospital, Neurology, Paris, France.
  • Centre hospitalier universitaire de Nantes, Neurology Department, CR2TI-Inserm U1064, Nantes Université, France.
  • Neurology Department, Clinical Neuroscience Centre, CIC_P1414 INSERM, UMR_1236 MOBIDIC, University Hospital, Rennes, France.
  • UMPR 1104, Paris Cité University, France.
  • Hospital Pellegrin Bordeaux, Neurologie Pathologie inflammatoire du système nerveux central, France.
  • Inserm U1215-Neurocentre Magendie, Université de Bordeaux, France.
  • IGF, Univ Montpellier, CNRS, INSERM, Service de Neurologie, CHU Nimes, France.
  • University of Lille, Inserm U 1172, CHU of Lille, France.
  • Sorbonne Université, AP-HP, Pitie-Salpetriere University Hospital, Ophthalmology Department, Paris, France; and.
  • Sorbonne University, Paris-Brain Institute (ICM), Inserm U1127, CNRS UMR 7225.

Abstract

OBJECTIVES

Aquaporin 4-immunoglobulin G-seropositive neuromyelitis optica spectrum disorder (AQP4+NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are rare conditions with evolving diagnostic and therapeutic approaches. Our study aims to describe these evolutions in France, using data from the NOMADMUS cohort.

METHODS

We retrospectively analyzed clinical, imaging, and therapeutic data collected across 98 French centers as of June 8, 2024. Patients were classified based on serologic status into AQP4+NMOSD or MOGAD.

RESULTS

The cohort included 769 AQP4+NMOSD and 957 patients with MOGAD, 68.6% female with a mean age at onset of 37.4 years (18.3). The mean annualized relapse rates decreased from 2010-2014 to 2022-2023 in both groups (for example, from 0.45 (0.41-0.48) to 0.04 (0.03-0.05) in AQP4+NMOSD, Welch's t tests, p < 0.0001). Rituximab use increased in AQP4+NMOSD patients over time and was associated with a lower risk to reach Expanded Disability Status Scale (EDSS) 6 (HR 0.38; p < 0.001, 0.21-0.68). Risk to reach EDSS 3 or 6 was lower in patients with MOGAD compared with AQP4+NMOSD patients.

DISCUSSION

This nationwide registry revealed a reduction of the time to diagnosis, a decreased disease activity over time, and an evolution in the therapeutic strategies these past 15 years. This collaborative effort provides valuable insights into current knowledge about clinical practice and treatment patterns in real-world settings.

MeSH

Neuromyelitis Optica, Therapeutics, Neurology