TY - JOUR
T1 - Prognostic relevance of quantitative and longitudinal MOG antibody testing in patients with MOGAD: a multicentre retrospective study
AU - Gastaldi, Matteo
AU - Foiadelli, Thomas
AU - Greco, Giacomo
AU - Scaranzin, Silvia
AU - Rigoni, Eleonora
AU - Masciocchi, Stefano
AU - Ferrari, Sergio
AU - Mancinelli, Chiara
AU - Brambilla, Laura
AU - Mancardi, Margherita
AU - Giacomini, Thea
AU - Ferraro, Diana
AU - Della Corte, Marida
AU - Gallo, Antonio
AU - Di Filippo, Massimiliano
AU - Benedetti, Luana
AU - Novi, Giovanni
AU - Versino, Maurizio
AU - Banfi, Paola
AU - Iorio, Raffaele
AU - Moiola, Lucia
AU - Turco, Emanuela
AU - Sartori, Stefano
AU - Nosadini, Margherita
AU - Ruggieri, Martino
AU - Savasta, Salvatore
AU - Colombo, Elena
AU - Ballante, Elena
AU - Jarius, Sven
AU - Mariotto, Sara
AU - Franciotta, Diego
PY - 2023
Y1 - 2023
N2 - Background IgG antibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) define a subset of associated disorders (myelin oligodendrocyte glycoprotein associated disorders (MOGAD)) that can have a relapsing course. However, information on relapse predictors is scarce. The utility of retesting MOG-IgG over time and measuring their titres is uncertain. We aimed to evaluate the clinical relevance of longitudinal MOG-IgG titre measurement to predict relapses in patients with MOGAD. Methods In this retrospective multicentre Italian cohort study, we recruited patients with MOGAD and available longitudinal samples (at least one >3 months after disease onset) and tested them with a live cell-based assay with endpoint titration (1:160 cut-off). Samples were classified as € attack' (within 30 days since a disease attack (n=59, 17%)) and € remission' (≥31 days after attack (n=295, 83%)). Results We included 102 patients with MOGAD (57% adult and 43% paediatric) with a total of 354 samples (83% from remission and 17% from attack). Median titres were higher during attacks (1:1280 vs 1:640, p=0.001). Median onset titres did not correlate with attack-related disability, age or relapses. Remission titres were higher in relapsing patients (p=0.02). When considering the first remission sample available for each patient, titres >1:2560 were predictors of relapsing course in survival (log rank, p<0.001) and multivariate analysis (p<0.001, HR: 10.9, 95% CI 3.4 to 35.2). MOG-IgG seroconversion to negative was associated with a 95% relapse incidence rate reduction (incidence rate ratio: 0.05, p<0.001). Conclusions Persistent MOG-IgG positivity and high remission titres are associated with an increased relapse risk. Longitudinal MOG-IgG titres could be useful to stratify patients to be treated with long term immunosuppression. © 2023 Authors. All rights reserved
AB - Background IgG antibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) define a subset of associated disorders (myelin oligodendrocyte glycoprotein associated disorders (MOGAD)) that can have a relapsing course. However, information on relapse predictors is scarce. The utility of retesting MOG-IgG over time and measuring their titres is uncertain. We aimed to evaluate the clinical relevance of longitudinal MOG-IgG titre measurement to predict relapses in patients with MOGAD. Methods In this retrospective multicentre Italian cohort study, we recruited patients with MOGAD and available longitudinal samples (at least one >3 months after disease onset) and tested them with a live cell-based assay with endpoint titration (1:160 cut-off). Samples were classified as € attack' (within 30 days since a disease attack (n=59, 17%)) and € remission' (≥31 days after attack (n=295, 83%)). Results We included 102 patients with MOGAD (57% adult and 43% paediatric) with a total of 354 samples (83% from remission and 17% from attack). Median titres were higher during attacks (1:1280 vs 1:640, p=0.001). Median onset titres did not correlate with attack-related disability, age or relapses. Remission titres were higher in relapsing patients (p=0.02). When considering the first remission sample available for each patient, titres >1:2560 were predictors of relapsing course in survival (log rank, p<0.001) and multivariate analysis (p<0.001, HR: 10.9, 95% CI 3.4 to 35.2). MOG-IgG seroconversion to negative was associated with a 95% relapse incidence rate reduction (incidence rate ratio: 0.05, p<0.001). Conclusions Persistent MOG-IgG positivity and high remission titres are associated with an increased relapse risk. Longitudinal MOG-IgG titres could be useful to stratify patients to be treated with long term immunosuppression. © 2023 Authors. All rights reserved
KW - MULTIPLE SCLEROSIS
KW - MYELIN
KW - MYELOPATHY
KW - MULTIPLE SCLEROSIS
KW - MYELIN
KW - MYELOPATHY
UR - http://hdl.handle.net/10807/227879
U2 - 10.1136/jnnp-2022-330237
DO - 10.1136/jnnp-2022-330237
M3 - Article
SN - 0022-3050
VL - 94
SP - 201
EP - 210
JO - Journal of Neurology, Neurosurgery and Psychiatry
JF - Journal of Neurology, Neurosurgery and Psychiatry
ER -