MOG associated disease has been identified recently and resembles
MS and neuromyelitis optica.
Understanding how to diagnose early and how to treat is critical.
a) Improve early MOGAD diagnosis:
MOGAD can mimic MS and blood test to differentiate the two take weeks to return results. We have identified specific MRI features differentiating MOGAD from MS, which can be used at the time of first symptoms. These MRI features include the central vein sign (CVS), and paramagnetic rim lesions (PRLs).
Sacco S, Virupakshaiah A, Papinutto N, Schoeps VA, Akula A, Zhao H, Arona J, Stern WA, Chong J, Hart J, Zamvil SS, Sati P, Henry RG, Waubant E. Mult Scler. 2023 Dec;29(14):1736-1747. doi: 10.1177/13524585231204414. Epub 2023 Oct 28. PMID: 37897254
b) Predict MOGAD course:
Only 50% of patients with MOGAD experience relapses after a first event; thus, identifying those with a higher risk of relapse is key to optimizing management. Using a large national registry of 327 pediatric patients with MOGAD, we have found that females and Hispanics have a 50% increased risk to have relapses.
Predictors of a relapsing course in myelin oligodendrocyte glycoprotein antibody-associated disease.
Virupakshaiah A, Schoeps VA, Race J, Waltz M, Sharayah S, Nasr Z, Moseley CE, Zamvil SS, Gaudioso C, Schuette A, Casper TC, Rose J, Flanagan EP, Rodriguez M, Tillema JM, Chitnis T, Gorman MP, Graves JS, Benson LA, Rensel M, Abrams A, Krupp L, Lotze TE, Aaen G, Wheeler Y, Schreiner T, Waldman A, Chong J, Mar S, Waubant E. J Neurol Neurosurg Psychiatry. 2024 Dec 16;96(1):68-75. doi: 10.1136/jnnp-2024-333464. PMID: 38964848
c) Best treatment strategy for MOGAD:
We have also found that treatment with rituximab or IVIG prevents MOGAD relapses, while there is a negative impact of chronic steroid use. Publication under submission. Stay tuned ...
Real-world comparative effectiveness of treatments for relapse prevention in myelin oligodendrocyte glycoprotein antibody-associated disease.
Akash Virupakshaiah, Vinicius A. Schoeps, Jonathan Race, Claudia Gambrah-Lyles, Gina Chang, Michael Waltz, Parinaz Nasr, Carson E. Moseley, Scott S. Zamvil, Carla Francisco. Charles Casper, John Rose, Eoin P. Flanagan, Moses Rodriguez, Jan-Mendelt Tillema, Tanuja Chitnis, Mark P. Gorman, Leslie A. Benson, Jennifer S. Graves, Mary Rensel, Aaron Abrams, Lauren B. Krupp, Kimberly A. O’Neill, Timothy E Lotze, Kristen Fisher, Nikita Shukla, Gregory Aaen, Yolanda Wheeler, Teri Schreiner, Amy T. Waldman, Janet Chong, Emmanuelle Waubant, & Soe Mar, on behalf of the US Network of Pediatric MS Centers