Contributions
Abstract: EP1287
Type: ePoster
Abstract Category: Clinical aspects of MS - 1 Diagnosis and differential diagnosis
Introduction: Serum anti-Myelin Oligodendrocyte Glycoprotein antibodies (MOG-IgG) have been detected in patients with various demyelinating disorders. However, the lack of prospective studies leaves uncertainty on the clinical significance of MOG-IgG detection. This study is aimed at clarifying the diagnostic and prognostic value of MOG-IgG testing in patients with demyelinating events and presentation features atypical for MS.
Methods: 16 Italian centres will participate in the study. Eligible patients are aged 18-80 years, with a first demyelinating event occurred within 12 months from screening and not fulfilling 2010 McDonald criteria for MS. Each patient will be followed prospectively for 2 years, with baseline evaluation including clinical assessment, brain and spine MRI, lumbar puncture, and evoked potentials. Serum aquaporin4 (AQP4)-IgG and MOG-IgG testing will be performed at Verona Neuropathology Laboratory using a commercial fixed cell-based assay for AQP4-IgG and an in-house live cell-based immunofluorescence assay for MOG-Ig (positive cut-off titre ≥1:160). Clinical assessment will be repeated every 6 months, while MRI and evoked potentials annually. AQP4-IgG and MOG-IgG will be retested in case of relapse and every 6 months in seropositive patients.
Results: By May 2017, 15 patients (11 females) have been enrolled in 3 centres. Median onset age was 43 (25-59) years and follow-up duration was 6 (0-12) months. Clinical presentation was optic neuritis in 7, acute myelitis in 6, and other in 2 cases. Three patients were MOG-IgG positive at baseline, while one was AQP4-IgG positive. Compared to MOG-IgG negative, MOG-IgG positive cases had more frequently severe presentation (median EDSS score at nadir 2.0 vs. 3.5), longitudinally extensive spinal lesions on MRI (20% vs. 100%), CSF pleocytosis >50/µl (0 vs. 67%), and absence of CSF-restricted oligoclonal bands (30% vs. 67%). MOG-IgG assay was repeated at 6 months in 2 initially positive patients and it resulted negative in both cases.
Conclusions: In this prospective multicentre study we recruited adult patients with non-MS demyelinating events and we performed a comprehensive evaluation including serum AQP4-IgG and MOG-IgG assessment. Our results suggest that MOG-IgG positivity seems to be around 20% in this population and is associated with distinct MRI and CSF features. MOG-IgG needs to be tested as early as possible after clinical onset as seropositive cases may become negative in few months.
Disclosure:
Dr. Capra received consulting fees from Novartis, Biogen-Idec and lecture fees and/or travel grants from Novartis, Biogen-Idec, Genzyme and Sanofi-Aventis.
Dr. Ferraro has received travel grants and/or speaker honoraria from Merck Serono, Teva, Novartis, Biogen, Sanofi-Genzyme.
Dr. Gajofatto received speaker honoraria from Merck.
Abstract: EP1287
Type: ePoster
Abstract Category: Clinical aspects of MS - 1 Diagnosis and differential diagnosis
Introduction: Serum anti-Myelin Oligodendrocyte Glycoprotein antibodies (MOG-IgG) have been detected in patients with various demyelinating disorders. However, the lack of prospective studies leaves uncertainty on the clinical significance of MOG-IgG detection. This study is aimed at clarifying the diagnostic and prognostic value of MOG-IgG testing in patients with demyelinating events and presentation features atypical for MS.
Methods: 16 Italian centres will participate in the study. Eligible patients are aged 18-80 years, with a first demyelinating event occurred within 12 months from screening and not fulfilling 2010 McDonald criteria for MS. Each patient will be followed prospectively for 2 years, with baseline evaluation including clinical assessment, brain and spine MRI, lumbar puncture, and evoked potentials. Serum aquaporin4 (AQP4)-IgG and MOG-IgG testing will be performed at Verona Neuropathology Laboratory using a commercial fixed cell-based assay for AQP4-IgG and an in-house live cell-based immunofluorescence assay for MOG-Ig (positive cut-off titre ≥1:160). Clinical assessment will be repeated every 6 months, while MRI and evoked potentials annually. AQP4-IgG and MOG-IgG will be retested in case of relapse and every 6 months in seropositive patients.
Results: By May 2017, 15 patients (11 females) have been enrolled in 3 centres. Median onset age was 43 (25-59) years and follow-up duration was 6 (0-12) months. Clinical presentation was optic neuritis in 7, acute myelitis in 6, and other in 2 cases. Three patients were MOG-IgG positive at baseline, while one was AQP4-IgG positive. Compared to MOG-IgG negative, MOG-IgG positive cases had more frequently severe presentation (median EDSS score at nadir 2.0 vs. 3.5), longitudinally extensive spinal lesions on MRI (20% vs. 100%), CSF pleocytosis >50/µl (0 vs. 67%), and absence of CSF-restricted oligoclonal bands (30% vs. 67%). MOG-IgG assay was repeated at 6 months in 2 initially positive patients and it resulted negative in both cases.
Conclusions: In this prospective multicentre study we recruited adult patients with non-MS demyelinating events and we performed a comprehensive evaluation including serum AQP4-IgG and MOG-IgG assessment. Our results suggest that MOG-IgG positivity seems to be around 20% in this population and is associated with distinct MRI and CSF features. MOG-IgG needs to be tested as early as possible after clinical onset as seropositive cases may become negative in few months.
Disclosure:
Dr. Capra received consulting fees from Novartis, Biogen-Idec and lecture fees and/or travel grants from Novartis, Biogen-Idec, Genzyme and Sanofi-Aventis.
Dr. Ferraro has received travel grants and/or speaker honoraria from Merck Serono, Teva, Novartis, Biogen, Sanofi-Genzyme.
Dr. Gajofatto received speaker honoraria from Merck.