BackgroundIgG 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. MethodsIn 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%)). ResultsWe 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). ConclusionsPersistent 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.

Prognostic relevance of quantitative and longitudinal MOG antibody testing in patients with MOGAD: A multicentre retrospective study

Gastaldi M.
Membro del Collaboration Group
;
Ferraro D.
Membro del Collaboration Group
;
Gallo A.
Membro del Collaboration Group
;
Versino M.
Membro del Collaboration Group
;
Savasta S.
Membro del Collaboration Group
;
2023-01-01

Abstract

BackgroundIgG 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. MethodsIn 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%)). ResultsWe 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). ConclusionsPersistent 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
MULTIPLE SCLEROSIS; MYELIN; MYELOPATHY
Gastaldi, M.; Foiadelli, T.; Greco, G.; Scaranzin, S.; Rigoni, E.; Masciocchi, S.; Ferrari, S.; Mancinelli, C.; Brambilla, L.; Mancardi, M.; Giacomini, T.; Ferraro, D.; Della Corte, M.; Gallo, A.; Di Filippo, M.; Benedetti, L.; Novi, G.; Versino, M.; Banfi, P.; Iorio, R.; Moiola, L.; Turco, E.; Sartori, S.; Nosadini, M.; Ruggieri, M.; Savasta, S.; Colombo, E.; Ballante, E.; Jarius, S.; Mariotto, S.; Franciotta, D.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11383/2152371
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