Abstract Details

Title Treatment at Onset Predicts a Longer Time-to-Relapse After Index Event in Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD)

Topic Autoimmune Neurology

Presentation(s) S40 - Autoimmune Neurology: Stiff Person Syndrome/GAD65 Neurological Autoimmunity, CIDP, and MOGAD (5:06 PM-5:18 PM)

Poster/Presentation
Number 009

Background MOGAD is a demyelinating disorder which can cause optic neuritis, transverse myelitis or acute disseminated encephalomyelitis. It can be monophasic or relapsing. Predictors of time-to-second attack in patients with an index demyelinating event are unknown in MOGAD.

Objective To identify the predictors of time-to-second attack in patients with MOGAD.

Design/Methods Patients with a definite diagnosis of MOGAD, who tested positive for MOG-IgG and who are followed at Massachusetts General Hospital and Brigham and Women’s Hospital were included. Data on key clinical and demographic features including sex, age, race, treatment at onset, time-to-second attack and time to third attack were collected. A time-to-event survival analysis was performed using a Cox proportional hazards model. Univariate and multivariate regression analysis was performed.

Results We included 84 patients who had a definite diagnosis of MOGAD.The average age at first attack was 30 (IQR 17.0-46.5), and 62% of patients (n=52) were female. Median follow-up was 5.04 years (IQR 2.65-10.40). In total, 61% (n=51) of patients had a second attack, of which, 68% (n=35) experienced a third attack. After the first attack, 52% (n=42) patients were started on maintenance treatment. First available MOG titer was less than 1:100 in 29% of patients (n=25), and 1:00 or greater in 71% (n=51) of patients. Treatment status after the first attack significantly predicted longer time-to-second attack (HR = 0.46, 95% CI 0.23-0.92, p=0.028). Higher MOG titer did not predict time-to-second attack (HR=0.90, 95% CI 0.51-1.59, p=0.71). When adjusting for other covariates, MOG titers were not significantly associated with time-to-second attack.

Conclusions Early treatment after an index demyelinating event in MOGAD predicts a longer time-to-relapse, while MOG-IgG titer does not affect time-to-second attack.

Authors/Disclosures
Philippe-Antoine Bilodeau, MD (Massachusetts General Hospital) PRESENTER	The institution of Dr. Bilodeau has received research support from Alexion. The institution of Dr. Bilodeau has received research support from Sanofi.
Negar Molazadeh, MD	The institution of Dr. Molazadeh has received research support from Genentech, Inc..
Rebecca Salky	No disclosure on file
Gauruv Bose, MD (The University of Ottawa and Ottawa Hospital Research Institute)	Dr. Bose has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Bose has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Bose has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva Pharmaceuticals. The institution of Dr. Bose has received research support from Multiple Sclerosis Society of Canada.
Tanuja Chitnis, MD, FAAN (Brigham and Women's Hospital)	Dr. Chitnis has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Chitnis has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche-Genentech. Dr. Chitnis has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Siemens. Dr. Chitnis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Octave Biosciences. Dr. Chitnis has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Academic CME. The institution of Dr. Chitnis has received research support from Novartis. The institution of Dr. Chitnis has received research support from Sanofi. The institution of Dr. Chitnis has received research support from Octave. The institution of Dr. Chitnis has received research support from Genentech-Roche.
Michael Levy, MD, PhD, FAAN (Massachusetts General Hospital/Harvard Medical School)	Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Pharma. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB Pharma. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Levy has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various law firms. The institution of Dr. Levy has received research support from National Institutes Health.