Sex ratio and age of onset in AQP4 antibody-associated NMOSD: a review and meta-analysis.
Arnett S., Chew SH., Leitner U., Hor JY., Paul F., Yeaman MR., Levy M., Weinshenker BG., Banwell BL., Fujihara K., Abboud H., Dujmovic Basuroski I., Arrambide G., Neubrand VE., Quan C., Melamed E., Palace J., Sun J., Asgari N., Broadley SA., Guthy Jackson International Clinical Consortium* None.
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