A roadmap to increasing access to AQP4-Ig testing for NMOSD: expert recommendations

Raquel Vassão-Araujo; Samira Apóstolos; Angela Marie Jansen; Marco A. Lana-Peixoto; Antonio Pereira Gomes Neto; Mariana Rico-Restrepo; Soniza Vieira Alves-Leon; Douglas Kazutoshi Sato

doi:10.1055/s-0045-1801845

Arquivos de Neuro-Psiquiatria, Table of Contents

CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(02): s00451801845
DOI: 10.1055/s-0045-1801845

Review Article

A roadmap to increasing access to AQP4-Ig testing for NMOSD: expert recommendations

Raquel Vassão-Araujo

¹Santa Casa de Belo Horizonte (CAPPEM), Departamento de Neurologia, Belo Horizonte MG, Brazil.

²Crônicos do Dia a Dia, Inovação Científica e Pesquisa, Guarulhos SP, Brazil.

,

Samira Apóstolos

³Universidade de São Paulo, Departamento de Neurologia, São Paulo SP, Brazil.

,

Angela Marie Jansen

⁴Americas Health Foundation, Washington DC, United States.

,

Marco A. Lana-Peixoto

⁵Universidade Federal de Minas Gerais, Faculdade de Medicina, Centro de Pesquisas CIEM MS, Belo Horizonte MG, Brazil.

,

Antonio Pereira Gomes Neto

¹Santa Casa de Belo Horizonte (CAPPEM), Departamento de Neurologia, Belo Horizonte MG, Brazil.

,

Mariana Rico-Restrepo

⁶Americas Health Foundation, Bogota, Colombia.

,

Soniza Vieira Alves-Leon

⁷Universidade Federal do Estado do Rio de Janeiro, Departamento de eurologia, Rio de Janeiro RJ, Brazil.

⁸Universidade Federal do Rio de janeiro, Hospital Universitário Clementino Fraga Filho, Centro Pesquisa e Inovação, Rio de Janeiro RJ, Brazil.

,

Douglas Kazutoshi Sato

⁹Pontifícia Universidade Católica do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre RS, Brazil.

› Author Affiliations

Abstract

The discovery of aquaporin 4 immunoglobulin G (AQP4-IgG) autoantibody, present in ∼80% of patients with neuromyelitis optica spectrum disorder (NMOSD), dramatically improved its diagnosis, treatment, and prognosis. While Brazil has a higher prevalence of NMOSD (up to 4.5 per 100,000 people) compared with global averages, disparities in access to testing in Brazil impede early diagnosis and treatment. To tackle these issues, the Americas Health Foundation convened a three-day virtual conference with six Brazilian NMOSD experts. This paper emphasizes the importance of addressing the gaps in physicians' knowledge about NMOSD. Stakeholders, including government agencies, should develop national programs for continuing medical education. The public healthcare system should ensure the availability and accessibility of AQP4-IgG antibody testing. Clinical practice guidelines for NMOSD diagnosis and treatment must be established. Such guidelines will enable healthcare providers to manage patients promptly after the initial attack, reducing relapses and improving quality of life. Finally, addressing the fragmented healthcare system, including bridging the gap between public and private institutions and improving access to telemedicine, will aid individuals in Brazil with NMOSD in receiving early diagnosis and treatment. NMOSD presents unique challenges in Brazil because of its higher prevalence and limited access to crucial AQP4-IgG tests. Overcoming these challenges requires collaboration among experts, healthcare providers, government agencies, and the public healthcare system to improve diagnosis, treatment, and patient outcomes.

Keywords

Aquaporin 4 - Autoantibodies Diagnostic Techniques and Procedures - Healthcare Disparities - Neuromyelitis Optica

Bibliographical Record
Raquel Vassão-Araujo, Samira Apóstolos, Angela Marie Jansen, Marco A. Lana-Peixoto, Antonio Pereira Gomes Neto, Mariana Rico-Restrepo, Soniza Vieira Alves-Leon, Douglas Kazutoshi Sato. A roadmap to increasing access to AQP4-Ig testing for NMOSD: expert recommendations. Arq Neuropsiquiatr 2025; 83: s00451801845.
DOI: 10.1055/s-0045-1801845

Full Text

References

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