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Sex ratio and age of onset in AQP4 antibody-associated NMOSD: a review and meta-analysis

Arnett S 1 , Chew SH 2 , Leitner U 2 , Hor JY 3 , Paul F 4 , Yeaman MR 5 Show all authors , Levy M 6 , Weinshenker BG 7 , Banwell BL 8 , Fujihara K 9 , Abboud H 10 , Dujmovic Basuroski I 11 , Arrambide G 12 , Neubrand VE 13 , Quan C 14 , Melamed E 15 , Palace J 16 , Sun J 2 , Asgari N 17 , Broadley SA 2 , Guthy Jackson International Clinical Consortium*

Affiliations 

  • 1 School of Medicine and Dentistry, Gold Coast Campus, Griffith University, Gold Coast, QLD, 4222, Australia. simon.arnett@griffithuni.edu.au
  • 2 School of Medicine and Dentistry, Gold Coast Campus, Griffith University, Gold Coast, QLD, 4222, Australia
  • 3 Department of Neurology, Penang General Hospital, George Town, Penang, Malaysia
  • 4 NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
  • 5 Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
  • 6 Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
  • 7 Department of Neurology, University of Virginia, Charlottesville, VA, USA
  • 8 Division of Child Neurology, Children's Hospital of Philadelphia, Department of Neurology and Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
  • 9 Department of Multiple Sclerosis Therapeutics, Fukushima Medical University and Multiple Sclerosis and Neuromyelitis Optica Center, Southern Tohoku Research Institute for Neuroscience, Koriyama, Japan
  • 10 Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
  • 11 Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
  • 12 Neurology-Neuroimmunology Department, Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Catalonia, Spain
  • 13 Department of Cell Biology, Faculty of Sciences, University of Granada, Granada, Spain
  • 14 Department of Neurology, The National Centre for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
  • 15 Dell Medical School, University of Texas, Austin, TX, USA
  • 16 Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK
  • 17 Department of Neurology, Slagelse Hospital, Slagelse, Denmark
J Neurol, 2024 Aug;271(8):4794-4812.
PMID: 38958756 DOI: 10.1007/s00415-024-12452-8

Abstract

BACKGROUND: Aquaporin-4 (AQP4) antibody-associated neuromyelitis optica spectrum disorder (NMOSD) is an antibody-mediated inflammatory disease of the central nervous system. We have undertaken a systematic review and meta-analysis to ascertain the sex ratio and mean age of onset for AQP4 antibody associated NMOSD. We have also explored factors that impact on these demographic data.

METHODS: A systematic search of databases was conducted according to the PRISMA guidelines. Articles reporting sex distribution and age of onset for AQP4 antibody-associated NMSOD were reviewed. An initially inclusive approach involving exploration with regression meta-analysis was followed by an analysis of just AQP4 antibody positive cases.

RESULTS: A total of 528 articles were screened to yield 89 articles covering 19,415 individuals from 88 population samples. The female:male sex ratio was significantly influenced by the proportion of AQP4 antibody positive cases in the samples studied (p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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