Intravenous immunoglobulin treatment for acute attacks in myelin oligodendrocyte glycoprotein antibody disease

BACKGROUND: The potential therapeutic benefit of intravenous immunoglobulins (IVIGs) for acute attacks of myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is unknown. OBJECTIVE: The objective was to describe the outcomes of IVIG treatment for acute MOGAD attacks. METHODS: A retrospective observational study involving seven tertiary neuroimmunology centers. Data collection included patients' demographics, Expanded Disability Status Scale (EDSS), and visual acuity (VA) before the attack, at the nadir of the attack before IVIG treatment, and at follow-up visits ⩾3 months after treatment. RESULTS: Thirty-nine patients were included, of which 21 (53.8%) were female. The median age was 23 years (range 5-74 years), and the median disease duration was 4 months (range 0-93 months). The most common type of attack treated with IVIG was isolated optic neuritis (ON) (unilateral n = 14, bilateral n = 5, associated with transverse myelitis (TM), n = 1), followed by acute disseminated encephalomyelitis (ADEM) (n = 8), multifocal (n = 7), TM (n = 3), brainstem (n = 1), and other encephalitis (n = 1). A significant improvement in both the EDSS and VA measures was observed at follow-up compared to the time of IVIG treatment initiation (p < 0.0001 for both outcome measures). CONCLUSION: IVIG may be an effective treatment option for acute MOGAD attacks. Further prospective studies are warranted to validate our results

Treatment of myelin oligodendrocyte glycoprotein antibody associated disease with subcutaneous immune globulin

Myelin oligodendrocyte glycoprotein (MOG)-antibody associated disease (MOGAD) is a distinct demyelinating disease of the central nervous system that often exhibits a relapsing course. Immune globulin (Ig) therapy has been proposed as maintenance therapy to prevent relapses in MOGAD, but existing reports are limited to the use of intravenous Ig (IVIG). Subcutaneous Ig (SCIG) may exhibit several advantages over IVIG, including self-administration and less systemic adverse effects. Herein, we report six patients with MOGAD who were treated with subcutaneous Ig (SCIG) with good tolerability and without any relapses during follow-up. This supports the rationale for prospective randomized studies of SCIG in MOGAD

Low mortality rate in a large cohort of myelin oligodendrocyte glycoprotein antibody disease (MOGAD)

Abstract The mortality rates of individuals with myelin oligodendrocyte glycoprotein antibody disease (MOGAD) are currently unknown. This study aimed to assess the mortality rate in a large cohort of patients with MOGAD. Since none of the patients in our cohort died, we estimated the upper limit of a 95% confidence interval of the crude mortality rate in the cohort to be 2.1%. These data suggest that mortality in MOGAD is lower than that reported in other neuroinflammatory diseases and comparable to the age‐adjusted mortality rates of the general population in the United States. Additional studies are warranted to confirm this observation