Evidence for and against subclinical disease activity and progressive disease in MOG antibody disease and neuromyelitis optica spectrum disorder

Molazadeh, Negar; Filippatou, Angeliki; Vasileiou, Eleni S; Lévy, Michaël; Sotirchos, Elias S.

doi:10.1016/j.jneuroim.2021.577702

Cited by 17 publications

(10 citation statements)

References 183 publications

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“…Similar to NMOSD, the accumulation of disability is primarily driven by attacks. 16,17 Some degree of permanent neurological disability has been reported in as many as 47% of adult MOGAD patients, 18 with up to 60% resulting from the onset attack. 19 While high-dose CS treatment is generally used as a first-line treatment for acute attacks, Jarius et al reported complete or almost complete recovery in only 50% of 122 attacks treated with IVMP as a sole treatment, with the remaining having partial (44%) or no or almost no recovery (6%).…”

Section: Discussionmentioning

confidence: 99%

Intravenous immunoglobulin treatment for acute attacks in myelin oligodendrocyte glycoprotein antibody disease

et al. 2023

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Background: The potential therapeutic benefit of intravenous immunoglobulins (IVIGs) for acute attacks of myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is unknown. Objective: The objective was to describe the outcomes of IVIG treatment for acute MOGAD attacks. Methods: A retrospective observational study involving seven tertiary neuroimmunology centers. Data collection included patients’ demographics, Expanded Disability Status Scale (EDSS), and visual acuity (VA) before the attack, at the nadir of the attack before IVIG treatment, and at follow-up visits ⩾3 months after treatment. Results: Thirty-nine patients were included, of which 21 (53.8%) were female. The median age was 23 years (range 5–74 years), and the median disease duration was 4 months (range 0–93 months). The most common type of attack treated with IVIG was isolated optic neuritis (ON) (unilateral n = 14, bilateral n = 5, associated with transverse myelitis (TM), n = 1), followed by acute disseminated encephalomyelitis (ADEM) ( n = 8), multifocal ( n = 7), TM ( n = 3), brainstem ( n = 1), and other encephalitis ( n = 1). A significant improvement in both the EDSS and VA measures was observed at follow-up compared to the time of IVIG treatment initiation ( p < 0.0001 for both outcome measures). Conclusion: IVIG may be an effective treatment option for acute MOGAD attacks. Further prospective studies are warranted to validate our results.

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Section: Discussionmentioning

confidence: 99%

Intravenous immunoglobulin treatment for acute attacks in myelin oligodendrocyte glycoprotein antibody disease

et al. 2023

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“…99,143 Some evidence of subclinical disease activity and progression has been shown to be present in some of the patients with MOGAD. 2 Patients with anti-NMDAR-EN tend to have more severe neurologic presentations, and poor long-term functional outcomes, and the mortality rate has been reported between 5% and 7%. 144–146 In their study of 23 patients with overlapping demyelinating syndrome and anti-NMDAR-EN, Titaluer et al demonstrate that the demyelinating episodes are more difficult to treat than anti-NMDAR-EN and often required more aggressive therapies, emphasizing the importance of its prompt diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Preliminary studies indicate that MOGAD has a more benign course and relatively better recovery from relapses in most patients compared to AQP4-IgG + NMOSD. 2 …”

Section: Introductionmentioning

confidence: 99%

“…Preliminary studies indicate that MOGAD has a more benign course and relatively better recovery from relapses in most patients compared to AQP4-IgG + NMOSD. 2 Identifying associations among autoimmune diseases is important in patients with CNS demyelinating disorders because it may change the therapeutic strategies, monitoring approaches and intervals, and prognosis of both CNS inflammatory diseases and the co-existing autoimmune entity. 3 The underlying mechanisms of autoimmunity and autoantibody production in autoantibody-associated neurological syndromes are still unclear.…”

Section: Introductionmentioning

confidence: 99%

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Autoimmune diseases and cancers overlapping with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD): A systematic review

Molazadeh

Bose

Lotan

et al. 2022

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Background Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) has various similarities with AQP4-IgG-seropositive Neuromyelitis Optica Spectrum Disorder (AQP4-IgG + NMOSD) in terms of clinical presentations, magnetic resonance imaging (MRI) findings, and response to treatment. But unlike AQP4-IgG + NMOSD, which is known to coexist with various autoimmune diseases and cancers, an association of MOGAD with these conditions is less clear. Methods We conducted a systematic search in PubMed, Scopus, Web of Science, and Embase based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA). Duplicates were removed using Mendeley 1.19.8 (USA production) and the citations were uploaded into Covidence systematic review platform for screening. Results The most common autoimmune disease overlapping with MOGAD was anti-N-Methyl-D-Aspartate receptor encephalitis (anti-NMDAR-EN), followed by autoimmune thyroid disorders, and the most common autoantibody was antinuclear antibody (ANA), followed by AQP4-IgG (double-positive MOG-IgG and AQP4-IgG). A few sporadic cases of cancers and MOG-IgG-associated paraneoplastic encephalomyelitis were found. Conclusion Unlike AQP4-IgG + NMOSD, MOGAD lacks clustering of autoimmune diseases and autoantibodies associated with systemic and organ-specific autoimmunity. Other than anti-NMDAR-EN and perhaps AQP4-IgG + NMOSD, the evidence thus far does not support the need for routine screening of overlapping autoimmunity and neoplasms in patients with MOGAD.

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“… 9 MOGAD can be a monophasic disease or follow a relapsing course, but in contrast to MS, a slow and gradually progressive course does not appear to occur. 10 Common clinical manifestations include optic neuritis (ON) which is frequently bilateral, transverse myelitis (TM), acute disseminated encephalomyelitis (ADEM), and encephalitis. 9 , 11 Serum myelin oligodendrocyte glycoprotein IgG seropositivity, along with a compatible clinico-radiological presentation, confirms a diagnosis of MOGAD.…”

Section: Introductionmentioning

confidence: 99%

Fatigue is a common symptom in myelin oligodendrocyte glycoprotein antibody disease

Ladakis

Gould²,

Khazen³

et al. 2022

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Background Unlike multiple sclerosis and neuromyelitis optica, the burden of fatigue in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is unclear. Objective To compare fatigue levels between people with MOGAD and household controls (HC) and explore factors associated with fatigue severity. Methods In a cross-sectional survey, data were collected from people with MOGAD and HC by utilizing an online questionnaire. Data elements included demographics, sleep quality measures, comorbidities, MOGAD characteristics, and fatigue severity measured by the Modified Fatigue Impact Scale (MFIS). We compared fatigue severity between MOGAD participants and HC and assessed the associations between demographic and disease characteristics and fatigue severity. Results There were 180/283 MOGAD and 61/126 HC respondents. Compared to HC, people with MOGAD reported more severe fatigue, as measured by the MFIS total score (49.3 vs. 36.5; p < 0.001), and a larger proportion of MOGAD participants (75.6% vs. 44.3%; p < 0.001) were classified as fatigued. Among MOGAD participants, higher age ( p = 0.04), history of bilateral optic neuritis ( p = 0.02), and current use of acute treatment ( p = 0.04) were independently associated with higher fatigue. Conclusions Fatigue is common in people with MOGAD, and a history of bilateral optic neuritis, comorbid conditions, and ongoing disease activity appear to contribute to fatigue severity.

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Evidence for and against subclinical disease activity and progressive disease in MOG antibody disease and neuromyelitis optica spectrum disorder

Cited by 17 publications

References 183 publications

Intravenous immunoglobulin treatment for acute attacks in myelin oligodendrocyte glycoprotein antibody disease

Intravenous immunoglobulin treatment for acute attacks in myelin oligodendrocyte glycoprotein antibody disease

Autoimmune diseases and cancers overlapping with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD): A systematic review

Fatigue is a common symptom in myelin oligodendrocyte glycoprotein antibody disease

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