ECTRIMS eLearning

Long-term outcomes in MOG-IgG+ Optic Neuritis
ECTRIMS Learn. da Costa B. 10/25/17; 199452; EP1432
Bruna K. da Costa
Bruna K. da Costa
Contributions
Abstract

Abstract: EP1432

Type: ePoster

Abstract Category: Clinical aspects of MS - 10 Neuro-ophthalmology

Introduction: The association between Optic Neuritis (ON) and autoantibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) have been reported by several groups but there are still not definite recommendations about long-term treatments to prevent recurrences. In this study, we evaluated the clinical characteristics and the long-term recurrence of our MOG-IgG positive ON cases.
Methods and results: We included all patients who presented with isolated ON between December 2014 and December 2015 in a tertiary center in South Brazil. We excluded patients diagnosed with Neuromyelitis Optica Spectrum Disorders (NMOSD) and Multiple Sclerosis (MS). We included 6 ON cases who were MOG-IgG+ and negative to aquaporin-4-IgG using in-house live cell-based assays. They were mainly male (4 males and 2 females), with a mean age of 47 years and all patients, except one, presented bilateral and/or recurrent ON. The brain MRI of all MOG-IgG+ patients was normal or had unspecific white matter T2 lesions. Five patients were followed for a median of 53 (range 43-120) months, but one patient did not return for follow-up visits. Three patients did not present any other attack. Two patients had recurrent ON attacks during follow-up. Three patients received azathioprine. One patient with recurrent ON had persistent MOG-IgG+ at the last visit.
Discussion: Previous studies found higher frequencies of recurrent ON in MOG-IgG+ patients, but we observed recurrence in only two MOG-IgG+ patients in a cohort with a first ON attack. Although based on a small sample, our results suggest a significant portion of patients with a single attack, indicating a benign course when comparing to NMOSD and MS.
Conclusion: The MOG-IgG+ ON apparently have a benign course with low number of relapses, but the use of long-term immunosuppression may be considered in relapsing and severe cases with persistent MOG-IgG+.
Disclosure:
Dr. da Costa receives PhD scholarship from CNPq of Brazil.
Mr. Sommer has nothing to disclose.
Dr Passos had temporary internship posisition at Novartis.
Dr. Becker received speaking honoraria and research or travel grants and served as an expert for advisory boards for BayerHealth Care, Biogen, Merck Serono, Novartis, Roche, Sanofi Genzyme and Teva.
Dr. Sato received grant-in-aid for scientific research from the Japan Society for the Promotion of Science (KAKENHI 15K19472), research support from CAPES/Brasil (CSF-PAJT - 88887.091277/2014-00), advisory board honoraria from Shire and Merck, and speaker honoraria from Novartis, Genzyme, Merck, Biogen, and Teva.

Abstract: EP1432

Type: ePoster

Abstract Category: Clinical aspects of MS - 10 Neuro-ophthalmology

Introduction: The association between Optic Neuritis (ON) and autoantibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) have been reported by several groups but there are still not definite recommendations about long-term treatments to prevent recurrences. In this study, we evaluated the clinical characteristics and the long-term recurrence of our MOG-IgG positive ON cases.
Methods and results: We included all patients who presented with isolated ON between December 2014 and December 2015 in a tertiary center in South Brazil. We excluded patients diagnosed with Neuromyelitis Optica Spectrum Disorders (NMOSD) and Multiple Sclerosis (MS). We included 6 ON cases who were MOG-IgG+ and negative to aquaporin-4-IgG using in-house live cell-based assays. They were mainly male (4 males and 2 females), with a mean age of 47 years and all patients, except one, presented bilateral and/or recurrent ON. The brain MRI of all MOG-IgG+ patients was normal or had unspecific white matter T2 lesions. Five patients were followed for a median of 53 (range 43-120) months, but one patient did not return for follow-up visits. Three patients did not present any other attack. Two patients had recurrent ON attacks during follow-up. Three patients received azathioprine. One patient with recurrent ON had persistent MOG-IgG+ at the last visit.
Discussion: Previous studies found higher frequencies of recurrent ON in MOG-IgG+ patients, but we observed recurrence in only two MOG-IgG+ patients in a cohort with a first ON attack. Although based on a small sample, our results suggest a significant portion of patients with a single attack, indicating a benign course when comparing to NMOSD and MS.
Conclusion: The MOG-IgG+ ON apparently have a benign course with low number of relapses, but the use of long-term immunosuppression may be considered in relapsing and severe cases with persistent MOG-IgG+.
Disclosure:
Dr. da Costa receives PhD scholarship from CNPq of Brazil.
Mr. Sommer has nothing to disclose.
Dr Passos had temporary internship posisition at Novartis.
Dr. Becker received speaking honoraria and research or travel grants and served as an expert for advisory boards for BayerHealth Care, Biogen, Merck Serono, Novartis, Roche, Sanofi Genzyme and Teva.
Dr. Sato received grant-in-aid for scientific research from the Japan Society for the Promotion of Science (KAKENHI 15K19472), research support from CAPES/Brasil (CSF-PAJT - 88887.091277/2014-00), advisory board honoraria from Shire and Merck, and speaker honoraria from Novartis, Genzyme, Merck, Biogen, and Teva.

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