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Early Maintenance Treatment Initiation and Relapse Risk Mitigation After a First Event of MOGAD in Adults: The MOGADOR2 Study.
Deschamps, Romain; Guillaume, Jessica; Ciron, Jonathan; Audoin, Bertrand; Ruet, Aurélie; Maillart, Elisabeth; Pique, Julie; Benyahya, Lakhdar; Laplaud, David A; Michel, Laure; Collongues, Nicolas; Cohen, Mikael; Ayrignac, Xavier; Thouvenot, Eric; Zephir, Helene; Bourre, Bertrand; Froment Tilikete, Caroline; Moreau, Thibault; Cantagrel, Paul; Kerschen, Philippe; Cabasson, Sebastien; Maubeuge, Nicolas; Hankiewicz, Karolina; Nifle, Chantal; Berger, Eric; Megherbi, Hana; Magy, Laurent; Klapczynski, Frederic; Sarov Riviere, Mariana; Giannesini, Claire; Hamelin, Lorraine; Giroux, Marianne; Branger, Pierre; Maurousset, Aude; Mathey, Guillaume; Moulin, Maximilien; Mélé, Nicolas; Papeix, Caroline; Marignier, Romain.
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  • Deschamps R; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Guillaume J; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Ciron J; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Audoin B; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Ruet A; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Maillart E; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Pique J; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Benyahya L; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Laplaud DA; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Michel L; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Collongues N; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Cohen M; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Ayrignac X; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Thouvenot E; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Zephir H; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Bourre B; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Froment Tilikete C; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Moreau T; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Cantagrel P; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Kerschen P; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Cabasson S; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Maubeuge N; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Hankiewicz K; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Nifle C; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Berger E; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Megherbi H; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Magy L; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Klapczynski F; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Sarov Riviere M; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Giannesini C; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Hamelin L; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Giroux M; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Branger P; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Maurousset A; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Mathey G; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Moulin M; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Mélé N; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Papeix C; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
  • Marignier R; From the Department of Neurology (R.D.); Clinical Research Department (J.G.), Rothschild Foundation Hospital, Paris; Department of Neurology (J.C.), University Hospital of Toulouse; Department of Neurology (B.A.), Pôle de Neurosciences Cliniques, APHM, Aix Marseille University, Hôpital de la Timone;
Neurology ; 103(3): e209624, 2024 Aug 13.
Article en En | MEDLINE | ID: mdl-38991174
ABSTRACT
BACKGROUND AND

OBJECTIVES:

Because myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a recently identified autoimmune disorder, the natural history of MOGAD is still not well described. The objective of this study was to describe the long-term outcomes of adult patients with MOGAD. In addition, we aimed to identify factors affecting relapse risk and neurologic outcomes.

METHODS:

Clinical and biological data were obtained from patients with a first event of MOGAD and included in the French nationwide incident cohort between February 2014 and March 2017. Only patients aged 18 years or older at disease onset and with observation period of at least 3 months were included. Data were collected prospectively until July 2023 and registered in the dedicated French nationwide database. This form includes every relapse with phenotype description during follow-up, date of last assessment, final clinical outcome with Expanded Disability Status Scale score and visual acuity, and maintenance therapy. The probability of recurrence-free survival was assessed using the Kaplan-Meier method.

RESULTS:

We included 128 patients. The onset phenotype was isolated optic neuritis in 81 patients (63.3%) and isolated myelitis in 25 patients (19.5%). The median follow-up duration was 77.8 months (range 3.2-111.2), with 49 patients (38.3%) experienced at least one relapse. Median times from onset to second and third attacks were 3.2 (1.0-86.2) and 13.0 (2.6-64.4) months, respectively. At the last assessment, Expanded Disability Status Scale Score was ≥3 and ≥6 in 22 (17.2%) and 6 (4.7%) patients, respectively. Eighty patients received at least one maintenance treatment. This treatment was initiated after the first attack in 47 patients (36.7% of the whole cohort) and at the time of a second attack in 25 (19.5%). Multivariate analysis revealed that initiating maintenance treatment after the first attack was associated with a lower relapse risk (OR = 0.26 [95% CI 0.11-0.62], p = 0.002). In patients receiving maintenance therapy after first attack, the 2-year, 4-year, 6-year, and 8-year relapse risks were 11%, 15%, 20%, and 20%, respectively. In other patients, the risks were 41%, 46%, 51%, and 56%.

DISCUSSION:

The highest risk of a relapse in MOGAD occurs early, and initiating maintenance therapy from the first attack substantially reduced the relapse risk. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that initiating maintenance therapy from the first attack in patients with MOGAD reduces the relapse risk.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recurrencia / Glicoproteína Mielina-Oligodendrócito Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Neurology Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recurrencia / Glicoproteína Mielina-Oligodendrócito Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Neurology Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos