Prognostic relevance of quantitative and longitudinal MOG antibody testing in patients with MOGAD: a multicentre retrospective study. Issue 3 (2nd December 2022)

• Record Type: Journal Article
• Authors: Gastaldi, Matteo; Foiadelli, Thomas; Greco, Giacomo; Scaranzin, Silvia; Rigoni, Eleonora; Masciocchi, Stefano; Ferrari, Sergio; Mancinelli, Chiara; Brambilla, Laura; Mancardi, Margherita; Giacomini, Thea; Ferraro, Diana; Della Corte, Marida; Gallo, Antonio; Di Filippo, Massimiliano; Benedetti, Luana; Novi, Giovanni; Versino, Maurizio; Banfi, Paola; Iorio, Raffaele; Moiola, Lucia; Turco, Emanuela; Sartori, Stefano; Nosadini, Margherita; Ruggieri, Martino; Savasta, Salvatore; Colombo, Elena; Ballante, Elena; Jarius, Sven; Mariotto, Sara; Franciotta, Diego;
• Other Names: author non-byline.; Rossi Francesca author non-byline.; Luigi Zulliani author non-byline.; Mampreso Edoardo author non-byline.; Gambara Silvia author non-byline.; Squilini Sabrina author non-byline.; Matricardi Sara author non-byline.; Clerici Valentina Torri author non-byline.; Polito Anna Nunzia author non-byline.; Rosa Gabriella Di author non-byline.; Bedin Roberta author non-byline.; Vitetta Francesca author non-byline.; Varone Antonio author non-byline.; Maimone Davide author non-byline.; Bisecco Alvino author non-byline.; Sabatino Elena Di author non-byline.; Scannapieco Sara author non-byline.; Papi Claudia author non-byline.; Guerrieri Simone author non-byline.; Pisani Francesco author non-byline.; Praticò Andrea author non-byline.; Po Chiara author non-byline.; Grazian Luisa author non-byline.; Passarini Alice author non-byline.; Bergamoni Stefania author non-byline.; Rasia Sasha author non-byline.; Bergamaschi Roberto author non-byline.; Marchioni Enrico author non-byline.
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 94:Issue 3(2023)
• Page Start: 201
• Page End: 210
• Publication Date: 2022-12-02
• Subjects: MULTIPLE SCLEROSIS -- MYELOPATHY -- MYELIN; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2022-330237
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background: IgG antibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) define a subset of associated disorders (myelin oligodendrocyte glycoprotein associated disorders (MOGAD)) that can have a relapsing course. However, information on relapse predictors is scarce. The utility of retesting MOG-IgG over time and measuring their titres is uncertain. We aimed to evaluate the clinical relevance of longitudinal MOG-IgG titre measurement to predict relapses in patients with MOGAD. Methods: In this retrospective multicentre Italian cohort study, we recruited patients with MOGAD and available longitudinal samples (at least one >3 months after disease onset) and tested them with a live cell-based assay with endpoint titration (1:160 cut-off). Samples were classified as 'attack' (within 30 days since a disease attack (n=59, 17%)) and 'remission' (≥31 days after attack (n=295, 83%)). Results: We included 102 patients with MOGAD (57% adult and 43% paediatric) with a total of 354 samples (83% from remission and 17% from attack). Median titres were higher during attacks (1:1280 vs 1:640, p=0.001). Median onset titres did not correlate with attack-related disability, age or relapses. Remission titres were higher in relapsing patients (p=0.02). When considering the first remission sample available for each patient, titres >1:2560 were predictors of relapsing course in survival (log rank, p<0.001) and multivariate analysis (p<0.001, HR: 10.9, 95% CI 3.4 to 35.2). MOG-IgG seroconversion to negative was associated with a 95% relapse incidence rate reduction (incidence rate ratio: 0.05, p<0.001). Conclusions: Persistent MOG-IgG positivity and high remission titres are associated with an increased relapse risk. Longitudinal MOG-IgG titres could be useful to stratify patients to be treated with long term immunosuppression.