Mortality in neuromyelitis optica is strongly associated with African ancestry

Neuromyelitis optica spectrum disorder (NMOSD) is a severe autoimmune disease of the optic nerve, spinal cord, and, less frequently, brain.1 Severity and degree of recovery from relapses are the factors that determine long-term visual and motor disability and mortality.1 Mortality rates in NMOSD worldwide range from 9% to 32%, depending on age, relapse rate, and recovery from attacks.2,3 In examining mortality data from 2 large, ethnically diverse NMOSD Centers in the Mid-Atlantic United States, we observed a striking race distribution: most deceased patients were of African ancestry. In this analysis, we focus on race as a risk factor for mortality in NMOSD.