Objective To understand the employment impacts of myelin oligodendrocyte glycoprotein associated antibody disease (MOGAD) on adult patients in an international cohort by determining lost employment, work hours, and wages.

Background The impact of MOGAD on livelihoods is not well known, especially internationally. Clinically, MOGAD can be associated with significant disability and predominantly presents in younger adults. However, the socioeconomic consequences of MOGAD in adults are barely reported.

Design/Methods Participants of potential working age (18-70 years old) with neurologist-diagnosed MOGAD were recruited from clinical sites in 13 countries, April 2022 - August 2023. Each participant completed a one-time survey on demographic variables, clinical history, symptoms, treatments, comorbidities, and multiple aspects of employment and income. Regression models were constructed to assess the variables with possible associations with post-MOGAD diagnosis (i) unemployment and (ii) change in work hours.

Results 117 participants (66.7% female, mean age 39.7 years, mean disease duration 5.2 years) were analyzed. 95 (81.2%) were on treatments. Employment post-MOGAD reduced from 74 (63.2%) to 57 (48.7%) and work hours reduced, on average, from 31.6 hours to 19.5 hours/week. 50 (42.7%) reported losing wages after diagnosis. 50 (42.7%) did not experience visual loss, 37 (31.6%) had unilateral visual loss, and 28 (23.9%) had bilateral visual loss. 37 (31.6%) had myelopathy. 41 (35.0%) reported moderate to high levels of pain, and 44 (37.6%) reported depressed mood. Residence in a high-income country is a statistically significant association for post-MOGAD diagnosis employment and more weekly work hours. Presence of depressed mood is associated with unemployment. MOGAD-related pain and history of myelitis are each associated with lost work hours.

Conclusions MOGAD can have significant impacts on adult employment. Among those who are employed, work hours decreased. The impact on unemployment was lower in high-income countries. Invisible symptoms including depressed mood and pain are potentially modifiable factors related to socioeconomic status in MOGAD.