Impact of Attacks

EVERY NMOSD ATTACK PUTS PATIENTS AT RISK FOR POTENTIALLY DEVASTATING AND IRREVERSIBLE DISABILITY1-3

Vision loss, pain, and paralysis are just some of the ways that neuromyelitis optica spectrum disorder (NMOSD) can have a lasting impact on your patients.4,5

This is a hypothetical patient.

PATIENTS WITH NMOSD OFTEN EXPERIENCE A HIGH BURDEN OF DISEASE6*

35% to 60%

of patients required an emergency room (ER) visit, and many had multiple visits.

~3 to 5

ER visits per patient, on average.

22% to 54%

of patients required inpatient admission.

~8 to 10

days spent in the hospital per admission, on average.

*

Based on a retrospective study of patients with NMSOD (N=1349, of whom 134 had highly active NMOSD with ≥2 relapses in 12 months) that evaluated healthcare use within 12 months of a patient’s first NMOSD encounter (index date) in a US administrative claims database. Respective numbers in the non-NMOSD control group (N=670) were 9.70% (of patients with ER visits), 0.49 (mean number of ER visits), 4.0% (of patients with inpatient admission), and 4.49 (average number of days/admission).6

VISION-LOSS RATES ARE HIGH4

At 5 years after onset, almost half (41%) of seropositive patients were expected to be legally blind in at least 1 eye, and 9% were expected to be legally blind in both eyes.†
†

Based on Kaplan-Meier analyses from a retrospective study of 140 patients with aquaporin-4 immunoglobulin G positive (AQP4-IgG+) NMOSD identified from Mayo Clinic records from 2005 to 2011.4

PAIN AND PARALYSIS CAN PREVENT MOBILITY7

Patients reported pain, mobility problems, sensory disability, and motor disability.‡
  • 76% of patients reported pain and discomfort‡
‡

Based on a study of 21 patients diagnosed with NMOSD per the 2015 International Panel for Neuromyelitis Optica Diagnostic criteria, and who completed the EQ-5D-5L questionnaire. Mean disease duration was 8.2 years; mean Expanded Disability Status Scale (EDSS) score was 5.0±1.8.7

DISABILITY MEASUREMENT SCALES

  • The Hauser Ambulation Index (HAI) is a rating scale used to assess mobility by evaluating the time and degree of assistance required to walk 25 feet. Scores range from 0 (asymptomatic and fully active) to 10 (bedridden). The patient is asked to walk a marked 25-foot course as quickly and as safely as possible. The examiner records the time and type of assistance (eg, cane, walker, crutches) needed8
  • The EDSS is a method of quantifying disability and monitoring changes in the level of disability over time. It is widely used in clinical trials and in the assessment of people with NMOSD and MS9
  • The EQ-5D-5L is a system used to measure health-related quality of life, as well as functional status10
WALLS

AT 5 YEARS AFTER DISEASE ONSET§

Approximately 1 out of 5 (22%) patients with AQP4-IgG+ NMOSD would require a walker (EDSS 6).4

Approximately 1 out of 11 (8%) patients with AQP4-IgG+ NMOSD would require a wheelchair (EDSS 8).4

§

Based on Kaplan-Meier analyses from a retrospective study of 140 patients with AQP4-IgG+ NMOSD identified from Mayo Clinic records from 2005 to 2011.4



Meet Arlin, a patient with AQP4-IgG+ NMOSD

SOME PATIENTS ARE DISPROPORTIONATELY AT RISK FOR NMOSD11

PATIENTS AT RISK

ATTACKS CAN BE RECURRENT AND MAY PREDICT FUTURE DISABILITY3,5

CYCLE OF ATTACKS
References: 1. Wingerchuk DM, Zhang I, Kielhorn A, et al. Network meta-analysis of Food and Drug Administration-approved treatment options for adults with aquaporin-4 immunoglobulin G-positive neuromyelitis optica spectrum disorder. Neurol Ther. 2022;11(1):123-135. 2. Winkler A, Wrzos C, Haberl M, et al. Blood-brain barrier resealing in neuromyelitis optica occurs independently of astrocyte regeneration. J Clin Invest. 2021;131(5):e141694. 3. Jarius S, Ruprecht K, Wildemann B, et al. Contrasting disease patterns in seropositive and seronegative neuromyelitis optica: a multicentre study of 175 patients. J Neuroinflammation. 2012;9:14. 4. Jiao Y, Fryer JP, Lennon VA, et al. Updated estimate of AQP4-IgG serostatus and disability outcome in neuromyelitis optica. Neurology. 2013;81(14):1197-1204. 5. Kitley J, Leite MI, Nakashima I, et al. Prognostic factors and disease course in aquaporin-4 antibody-positive patients with neuromyelitis optica spectrum disorder from the United Kingdom and Japan. Brain. 2012;135(pt 6):1834-1849. 6. Ajmera MR, Boscoe A, Mauskopf J, Candrilli SD, Levy M. Evaluation of comorbidities and health care resource use among patients with highly active neuromyelitis optica. J Neurol Sci. 2018;384:96-103. 7. Mealy MA, Boscoe A, Caro J, Levy M. Assessment of patients with neuromyelitis optica spectrum disorder using the EQ-5D. Int J MS Care. 2019;21(3):129-134. 8. National Multiple Sclerosis Society. Ambulation index. Nationalmssociety.org. Accessed August 16, 2022. https://www.nationalmssociety.org/For-Professionals/Researchers/Resources-for-MS-Researchers/Research-Tools/Clinical-Study-Measures/Ambulation-Index-(AI) 9. MS Trust. Expanded Disability Status Scale (EDSS). MStrust.org. Updated January 2020. Accessed August 16, 2022. https://mstrust.org.uk/a-z/expanded-disability-status-scale-edss 10. Oemar M, Janssen B. EQ-5D-5L User Guide. University of Nebraska Medical Center. Updated October 2013. Accessed July 28, 2022. https://www.unmc.edu/centric/ _documents/EQ-5D-5L.pdf 11. Mealy MA, Kessler RA, Rimler Z, et al. Mortality in neuromyelitis optica is strongly associated with African ancestry. Neurol Neuroimmunol Neuroinflamm. 2018;5(4):e468.