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04.07.2020 | Original Communication

Treatment of MOG antibody associated disorders: results of an international survey

verfasst von: D. H. Whittam, V. Karthikeayan, E. Gibbons, R. Kneen, S. Chandratre, O. Ciccarelli, Y. Hacohen, J. de Seze, K. Deiva, R. Q. Hintzen, B. Wildemann, S. Jarius, I. Kleiter, K. Rostasy, P. Huppke, B. Hemmer, F. Paul, O. Aktas, A. K. Pröbstel, G. Arrambide, M. Tintore, M. P. Amato, M. Nosadini, M. M. Mancardi, M. Capobianco, Z. Illes, A. Siva, A. Altintas, G. Akman-Demir, L. Pandit, M. Apiwattankul, J. Y. Hor, S. Viswanathan, W. Qiu, H. J. Kim, I. Nakashima, K. Fujihara, S. Ramanathan, R. C. Dale, M. Boggild, S. Broadley, M. A. Lana-Peixoto, D. K. Sato, S. Tenembaum, P. Cabre, D. M. Wingerchuk, B. G. Weinshenker, B. Greenberg, M. Matiello, E. C. Klawiter, J. L. Bennett, A. I. Wallach, I. Kister, B. L. Banwell, A. Traboulsee, D. Pohl, J. Palace, M. I. Leite, M. Levy, R. Marignier, T. Solomon, M. Lim, S. Huda, A. Jacob

Erschienen in: Journal of Neurology | Ausgabe 12/2020

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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.

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Titel: Treatment of MOG antibody associated disorders: results of an international survey
verfasst von: D. H. Whittam
V. Karthikeayan
E. Gibbons
R. Kneen
S. Chandratre
O. Ciccarelli
Y. Hacohen
J. de Seze
K. Deiva
R. Q. Hintzen
B. Wildemann
S. Jarius
I. Kleiter
K. Rostasy
P. Huppke
B. Hemmer
F. Paul
O. Aktas
A. K. Pröbstel
G. Arrambide
M. Tintore
M. P. Amato
M. Nosadini
M. M. Mancardi
M. Capobianco
Z. Illes
A. Siva
A. Altintas
G. Akman-Demir
L. Pandit
M. Apiwattankul
J. Y. Hor
S. Viswanathan
W. Qiu
H. J. Kim
I. Nakashima
K. Fujihara
S. Ramanathan
R. C. Dale
M. Boggild
S. Broadley
M. A. Lana-Peixoto
D. K. Sato
S. Tenembaum
P. Cabre
D. M. Wingerchuk
B. G. Weinshenker
B. Greenberg
M. Matiello
E. C. Klawiter
J. L. Bennett
A. I. Wallach
I. Kister
B. L. Banwell
A. Traboulsee
D. Pohl
J. Palace
M. I. Leite
M. Levy
R. Marignier
T. Solomon
M. Lim
S. Huda
A. Jacob
Publikationsdatum: 04.07.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 12/2020
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-10026-y

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Treatment of MOG antibody associated disorders: results of an international survey

Abstract

Introduction

Objective

Method

Results

Conclusion

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