anti-MOG unresponsive to most MS drugs
anti-MOG unresponsive to most MS drugs
Evaluation of treatment response in adults with relapsing MOG-Ab-associated disease.
https://www.ncbi.nlm.nih.gov/pubmed/31266527
BACKGROUND
Myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) are related to several acquired demyelinating syndromes in adults, but the therapeutic approach is currently unclear. We aimed to describe the response to different therapeutic strategies in adult patients with relapsing MOG-Ab-associated disease.
METHODS:
This is a retrospective study conducted in France and Spain including 125 relapsing MOG-Ab patients aged ≥ 18 years. First, we performed a survival analysis to investigate the relapse risk between treated and non-treated patients, performing a propensity score method based on the inverse probability of treatment weighting. Second, we assessed the annualised relapse rates (ARR), Expanded Disability Status Scale (EDSS) and visual acuity pre-treatment and on/end-treatment.
RESULTS:
Median age at onset was 34.1 years (range 18.0-67.1), the female to male ratio was 1.2:1, and 96% were Caucasian. At 5 years, 84% (95% confidence interval [CI], 77.1-89.8) patients relapsed. At the last follow-up, 66 (52.8%) received maintenance therapy. Patients initiating immunosuppressants (azathioprine, mycophenolate mophetil [MMF], rituximab) were at lower risk of new relapse in comparison to non-treated patients (HR, 0.41; 95CI%, 0.20-0.82; p = 0.011). Mean ARR (standard deviation) was reduced from 1.05(1.20) to 0.43(0.79) with azathioprine (n = 11; p = 0.041), from 1.20(1.11) to 0.23(0.60) with MMF (n = 11; p = 0.033), and from 1.08(0.98) to 0.43(0.89) with rituximab (n = 26; p = 0.012). Other immunosuppressants (methotrexate/mitoxantrone/cyclophosphamide; n = 5), or multiple sclerosis disease-modifying drugs (MS-DMD; n = 9), were not associated with significantly reduced ARR. Higher rates of freedom of EDSS progression were observed with azathioprine, MMF or rituximab.
CONCLUSION:
In adults with relapsing MOG-Ab-associated disease, immunosuppressant therapy (azathioprine, MMF and rituximab) is associated with reduced risk of relapse and better disability outcomes. Such an effect was not found in the few patients treated with MS-DMD.
-
- Similar Topics
- Replies
- Views
- Last post
-
-
1/6 of the children with MS are anti-MOG+
by frodo » Mon Jul 29, 2019 5:06 am » in MS Etiology and Pathogenesis - 0 Replies
- 495 Views
-
Last post by frodo
Mon Jul 29, 2019 5:06 am
-
-
-
Overlaps of MS with NMO and anti-MOG
by frodo » Wed Apr 29, 2020 2:11 am » in MS Etiology and Pathogenesis - 0 Replies
- 137 Views
-
Last post by frodo
Wed Apr 29, 2020 2:11 am
-
-
- 0 Replies
- 744 Views
-
Last post by Petr75
Tue Oct 22, 2019 10:33 am
-
- 0 Replies
- 230 Views
-
Last post by jimmylegs
Mon Nov 30, 2020 2:11 am
-
-
Anti-Angiogenesis therapy in MS
by frodo » Thu Jan 09, 2020 6:37 am » in MS Etiology and Pathogenesis - 0 Replies
- 775 Views
-
Last post by frodo
Thu Jan 09, 2020 6:37 am
-
-
-
10% of MS cases are due to anti-Neurofascin autoantibody
by frodo » Sun Apr 14, 2019 10:40 am » in General Discussion - 0 Replies
- 469 Views
-
Last post by frodo
Sun Apr 14, 2019 10:40 am
-
-
-
Vitamin D3's anti-inflammatory effect via IL-27 & TGF-B1
by NHE » Thu Jan 14, 2021 2:09 am » in Natural Approach - 0 Replies
- 47 Views
-
Last post by NHE
Thu Jan 14, 2021 2:09 am
-
-
-
Dawson fingers in anti-MOG disease
by frodo » Sat Jun 01, 2019 9:19 am » in MS Etiology and Pathogenesis - 0 Replies
- 529 Views
-
Last post by frodo
Sat Jun 01, 2019 9:19 am
-
-
-
Up to 10% of MS cases are due to anti-Neurofascin autoantibody
by frodo » Sun Apr 14, 2019 10:18 am » in MS Etiology and Pathogenesis - 0 Replies
- 438 Views
-
Last post by frodo
Sun Apr 14, 2019 10:18 am
-