Do early relapses predict the risk of long-term relapsing disease in an adult and paediatric cohort with MOGAD?

Item Type:	Article
Title:	Do early relapses predict the risk of long-term relapsing disease in an adult and paediatric cohort with MOGAD?
Creators Name:	Chen, B. and Gomez-Figueroa, E. and Redenbaugh, V. and Francis, A. and Satukijchai, C. and Wu, Y. and Messina, S. and Sa, M. and Woodhall, M. and Paul, F. and Robertson, N.P. and Lim, M. and Wassmer, E. and Kneen, R. and Huda, S. and Blain, C. and Halfpenny, C. and Hemingway, C. and O'Sullivan, E. and Hobart, J. and Fisniku, L.K. and Martin, R.J. and Dobson, R. and Cooper, S.A. and Williams, V. and Waters, P. and Chen, J.J. and Pittock, S.J. and Ramdas, S. and Leite, M.I. and Flanagan, E.P. and Geraldes, R. and Palace, J.
Abstract:	OBJECTIVE: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) can be monophasic or relapsing, with early relapse being a feature. However, the relevance of early relapse on longer-term relapse risk is unknown. Here, we investigate whether early relapses increase longer-term relapse risk in patients with MOGAD. METHODS: A retrospective analysis of 289 adult- and pediatric-onset patients with MOGAD followed for at least 2 years in 6 specialized referral centers. "Early relapses" were defined as attacks within the first 12 months from onset, with "very early relapses" defined within 30 to 90 days from onset and "delayed early relapses" defined within 90 to 365 days. "Long-term relapses" were defined as relapses beyond 12 months. Cox regression modeling and Kaplan-Meier survival analysis were used to estimate the long-term relapse risk and rate. RESULTS: Sixty-seven patients (23.2%) had early relapses with a median number of 1 event. Univariate analysis revealed an elevated risk for long-term relapses if any "early relapses" were present (hazard ratio [HR] = 2.11, p < 0.001), whether occurring during the first 3 months (HR = 2.70, p < 0.001) or the remaining 9 months (HR = 1.88, p = 0.001), with similar results yielded in the multivariate analysis. In children with onset below aged 12 years, only delayed early relapses were associated with an increased risk of long-term relapses (HR = 2.64, p = 0.026). INTERPRETATION: The presence of very early relapses and delayed early relapses within 12 months of onset in patients with MOGAD increases the risk of long-term relapsing disease, whereas a relapse within 90 days appears not to indicate a chronic inflammatory process in young pediatric-onset disease. ANN NEUROL 2023;94:508-517.
Keywords:	Autoantibodies, Chronic Disease, Myelin-Oligodendrocyte Glycoprotein, Recurrence, Retrospective Studies
Source:	Annals of Neurology
ISSN:	0364-5134
Publisher:	Wiley
Volume:	94
Number:	3
Page Range:	508-517
Date:	September 2023
Additional Information:	Erratum in: Ann Neurol 2024 Jan 18.
Official Publication:	https://doi.org/10.1002/ana.26731
PubMed:	View item in PubMed

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