Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Dec;268(12):4537-4548.
doi: 10.1007/s00415-020-10236-4. Epub 2020 Sep 30.

Efficacy and safety of long-term immunotherapy in adult patients with MOG antibody disease: a systematic analysis

Qianshuo Lu #  1 , Jingjing Luo #  1 , Hongjun Hao  1 , Ran Liu  1 , Haiqiang Jin  1 , Yunyi Jin  1 , Feng Gao  2
Affiliations
Review

Efficacy and safety of long-term immunotherapy in adult patients with MOG antibody disease: a systematic analysis

Qianshuo Lu et al. J Neurol. 2021 Dec.

Abstract

Objective: To summarise the evidence of the efficacy and safety of current long-term immunotherapies in patients with myelin oligodendrocyte glycoprotein antibody disease (MOG-AD).

Methods: We performed a sensitive literature search in MEDLINE and EMBASE for selected studies or case series discussing the long-term treatments and outcomes in adult patients with MOG-AD and conducted a qualitative analysis of each therapy.

Results: A total of 33 articles, including 712 patients with MOG-AD, matched our inclusion criteria, and seven kinds of drugs were analysed accordingly. Efficacy was mainly reflected by the change in the annual relapse rate before and after treatment. First, maintenance steroids, azathioprine, mycophenolate mofetil, and rituximab were demonstrated to be effective in multiple studies. However, relapses could still happen after therapy especially under specific circumstances. Second, regular intravenous immunoglobulin G (IVIG) and tocilizumab might be effective. IVIG reduced annual relapse rate and expanded disability status scale in five adult patients, and tocilizumab succeeded in preventing relapse in four refractory patients, though with scant evidence. Finally, multiple sclerosis-disease-modifying therapy seemed ineffective for patients with MOG-AD. As for safety, six patients experienced severe neutropenia during rituximab therapy. No other serious adverse events were reported for these treatments.

Conclusions: Several preventive immunotherapies have been demonstrated to be effective and safe for adult patients with MOG-AD; however, large controlled studies for subgroups with specific manifestations are still needed in the future.

Keywords: Long-term immunotherapies; Myelin oligodendrocyte glycoprotein antibody disease; Systematic review; Treatment and outcome.

PubMed Disclaimer

References

    1. Peschl P, Bradl M, Hoftberger R, Berger T, Reindl M (2017) Myelin oligodendrocyte glycoprotein: deciphering a target in inflammatory demyelinating diseases. Front Immunol 8:529. https://doi.org/10.3389/fimmu.2017.00529 - DOI - PubMed - PMC
    1. Johns TG, Bernard CC (1999) The structure and function of myelin oligodendrocyte glycoprotein. J Neurochem 72(1):1–9. https://doi.org/10.1046/j.1471-4159.1999.0720001.x - DOI - PubMed
    1. Reindl M, Di Pauli F, Rostasy K, Berger T (2013) The spectrum of MOG autoantibody-associated demyelinating diseases. Nat Rev Neurol 9(8):455–461. https://doi.org/10.1038/nrneurol.2013.118 - DOI - PubMed
    1. Wynford-Thomas R, Jacob A, Tomassini V (2019) Neurological update: MOG antibody disease. J Neurol 266(5):1280–1286. https://doi.org/10.1007/s00415-018-9122-2 - DOI
    1. Jarius S, Ruprecht K, Kleiter I, Borisow N, Asgari N, Pitarokoili K, Pache F, Stich O, Beume LA, Hümmert MW, Ringelstein M, Trebst C, Winkelmann A, Schwarz A, Buttmann M, Zimmermann H, Kuchling J, Franciotta D, Capobianco M, Siebert E, Lukas C, Korporal-Kuhnke M, Haas J, Fechner K, Brandt AU, Schanda K, Aktas O, Paul F, Reindl M, Wildemann B (2016) MOG-IgG in NMO and related disorders: A multicenter study of 50 patients. Part 2: Epidemiology, clinical presentation, radiological and laboratory features, treatment responses, and long-term outcome. J Neuroinflamm. https://doi.org/10.1186/s12974-016-0718-0 - DOI

LinkOut - more resources