Treatment of MOG antibody associated disorders: results of an international survey
File version
Author(s)
Karthikeayan, V
Gibbons, E
Kneen, R
Chandratre, S
Ciccarelli, O
Hacohen, Y
de Seze, J
Deiva, K
Hintzen, RQ
Wildemann, B
Jarius, S
Broadley, S
et al.
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
Size
File type(s)
Location
License
Abstract
Introduction: While monophasic and relapsing forms of myelin oligodendrocyte glycoprotein antibody associated disorders (MOGAD) are increasingly diagnosed world-wide, consensus on management is yet to be developed. Objective: To survey the current global clinical practice of clinicians treating MOGAD. Method: Neurologists worldwide with expertise in treating MOGAD participated in an online survey (February–April 2019). Results: Fifty-two responses were received (response rate 60.5%) from 86 invited experts, comprising adult (78.8%, 41/52) and paediatric (21.2%, 11/52) neurologists in 22 countries. All treat acute attacks with high dose corticosteroids. If recovery is incomplete, 71.2% (37/52) proceed next to plasma exchange (PE). 45.5% (5/11) of paediatric neurologists use IV immunoglobulin (IVIg) in preference to PE. Following an acute attack, 55.8% (29/52) of respondents typically continue corticosteroids for ≥ 3 months; though less commonly when treating children. After an index event, 60% (31/51) usually start steroid-sparing maintenance therapy (MT); after ≥ 2 attacks 92.3% (48/52) would start MT. Repeat MOG antibody status is used by 52.9% (27/51) to help decide on MT initiation. Commonly used first line MTs in adults are azathioprine (30.8%, 16/52), mycophenolate mofetil (25.0%, 13/52) and rituximab (17.3%, 9/52). In children, IVIg is the preferred first line MT (54.5%; 6/11). Treatment response is monitored by MRI (53.8%; 28/52), optical coherence tomography (23.1%; 12/52) and MOG antibody titres (36.5%; 19/52). Regardless of monitoring results, 25.0% (13/52) would not stop MT. Conclusion: Current treatment of MOGAD is highly variable, indicating a need for consensus-based treatment guidelines, while awaiting definitive clinical trials.
Journal Title
Journal of Neurology
Conference Title
Book Title
Edition
Volume
Issue
Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement
Item Access Status
Note
This publication has been entered in Griffith Research Online as an Advance Online Version.
Access the data
Related item(s)
Subject
Clinical sciences
Neurosciences
Science & Technology
Life Sciences & Biomedicine
Clinical Neurology
Myelin oligodendrocyte glycoprotein
Neurology
Persistent link to this record
Citation
Whittam, DH; Karthikeayan, V; Gibbons, E; Kneen, R; Chandratre, S; Ciccarelli, O; Hacohen, Y; de Seze, J; Deiva, K; Hintzen, RQ; Wildemann, B; Jarius, S; Broadley, S; et al., A, Treatment of MOG antibody associated disorders: results of an international survey, Journal of Neurology, 2020