Characterizing double-negative NMOSD

Antonio Malvaso, MD, IRCCS “C. Mondino” National Neurological Institute, University of Pavia, Pavia, Italy, discusses the findings of his systematic review and meta-analysis, which aimed to characterize double-negative neuromyelitis optica spectrum disorder (NMOSD). Dr Malvaso stresses that the clinical profile of double-negative NMOSD is poorly defined in the literature. The systematic review revealed a female to male ratio of 2:1. A relapsing course was seen in 66%, versus monophasic course recorded in 33%. From a clinical point of view, patients typically presented with isolated optic neuritis, isolated myelitis, or LETM. Dr Malvaso highlights that MRI results revealed MRI abnormalities in around two thirds of patients. Data from cerebrospinal fluid (CSF) analysis demonstrated that patients had pleocytosis and oligoclonal bands at rates consistent with AQP4-positive NMOSD. Mean annualized relapse ratio (ARR) was like that of AQP4-positive; however, it was worse than that of myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease. Dr Malvaso emphasizes the need for randomized clinical trials to assess treatment efficacy in this population. This interview took place at the European Academy of Neurology (EAN) Annual Meeting 2024 in Helsinki, Finland.
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