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Abstract Details

Clinical Phenotypes, Predictors of Relapse, and Response to Treatment in Myelin Oligodendrocyte Glycoprotein-Antibody Associated Disorders
Autoimmune Neurology
P13 - Poster Session 13 (5:30 PM-6:30 PM)
15-003
The aim of this study was to characterize the clinical phenotypes, predictors of relapse, and treatment responses associated with myelin oligodendrocyte glycoprotein-antibody (MOG-Ab) disorders in both children and adults. 
With the evolving spectrum of MOG-Ab disorders, treatment strategies remain diverse.  Predictors of relapse are largely unknown.

We analyzed clinical variables of interest from patients with MOG-Ab associated disorders from four large multiple sclerosis (MS) centers in the United States.  We performed summary statistics and ran a student’s t test for continuous variables and chi-squared test for categorical variables (SPSS).
51 patients were identified.   12 (24%) were children ≤ 17 years (mean 33 years [range 4 - 64]; 31 (61%) were female.  38 (75%) had a phenotype consistent with neuromyelitis optica spectrum disorder (NMOSD).  23 (45%) presented with unilateral optic neuritis (ON).  12 (24%) presented with bilateral ON.  6 (12%) presented with longitudinally extensive transverse myelitis (TM).  6 (12%) presented with short segment TM.  8 (16%) presented with simultaneous ON and TM.  5 (10%) presented with acute demyelinating encephalomyelitis (ADEM). 18/51 (35%) had a monophasic course.  Neither initial presentation, age at presentation, sex, race/ethnicity, pediatric-onset, or MOG positivity at follow up helped distinguish those who had a monophasic vs a relapsing course. 30% of patients with persistently positive MOG-Ab remained monophasic.  26% of those with a negative Ab at follow up continued to relapse.  34 (67%) received at least one maintenance non-steroid immunotherapy. ¼ patients (23%) relapsed despite initial maintenance immunotherapy. Patients received varied immunotherapies (rituximab n=21, mycophenolate n=4, azathioprine n=2, tocilizumab n=3, monthly IVIG n=2, glatiramer n=2). 
NMOSD phenotype is common in MOG-Ab disorders in both children and adults. Treatment approaches for MOG-mediated disease mimic that seen in NMOSD.  Relapses are common despite initiation of maintenance immunotherapy.  Predicting relapses in MOG-Ab mediated disorders remains an area that is not well understood. 
Authors/Disclosures
Wendy S. Vargas, MD (Sanofi)
PRESENTER 		Dr. Vargas has received personal compensation for serving as an employee of Sanofi.
Anusha Yeshokumar, MD (Icahn School of Medicine at Mount Sinai) Dr. Yeshokumar has nothing to disclose.
Seth N. Levin, MD (Biogen) Dr. Levin has received personal compensation for serving as an employee of Biogen. Dr. Levin has received stock or an ownership interest from Biogen.
Christopher Langston, MD (Montefiore Nyack Hospital) No disclosure on file
Claudiu I. Diaconu, MD (White Plains Hospital Physician Associates) No disclosure on file
Rebecca G. Straus Farber, MD (Columbia University Irving Medical Center) Dr. Straus Farber has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics.
Kiran Thakur, MD, FÂ鶹´«Ã½Ó³»­ (Columbia University College of Physicians and Surgeons) Dr. Thakur has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Delve Bio.
No disclosure on file
Kaho Onomichi Kaho Onomichi has nothing to disclose.
No disclosure on file
Michelle Fabian, MD, FÂ鶹´«Ã½Ó³»­ (Mount Sinai Hospital) Dr. Fabian has nothing to disclose.
Ilena George, MD The institution of Dr. George has received research support from Biogen.
Ilana B. Katz Sand, MD (Corinne Goldsmith Dickinson Center for MS) The institution of Dr. Katz Sand has received research support from National Multiple Sclerosis Society. The institution of Dr. Katz Sand has received research support from Hirschl Foundation. The institution of Dr. Katz Sand has received research support from National Institutes of Health. Dr. Katz Sand has received personal compensation in the range of $500-$4,999 for serving as a Conference presenter with Â鶹´«Ã½Ó³»­.
Sylvia Klineova, MD (Icahn School of Medicine At Mount Sinai) Dr. Klineova has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Klineova has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Klineova has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Klineova has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion.
Rachel Brandstadter, MD (University of Pennsylvania) Dr. Brandstadter has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion.
Sam H. Horng, MD, PhD The institution of Dr. Horng has received research support from National Institutes of Health . The institution of Dr. Horng has received research support from Jayne and Harvey Beker Foundation .
Fred D. Lublin, MD, FÂ鶹´«Ã½Ó³»­ (Icahn School of Medicine At Mount Sinai) Dr. Lublin has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche/Genentech. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurogene. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medimmune/Viela Bio/Horizon. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Receptos/Celgene/BMS. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Labcorp. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neuralight. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Entelexo. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen. Dr. Lublin has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Avotres. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Lublin has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Lublin has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for EMD Serono. Dr. Lublin has received personal compensation in the range of $100,000-$499,999 for serving as an Expert Witness for Multiple entities. Dr. Lublin has stock in Avotres. Dr. Lublin has stock in Neuralight. The institution of Dr. Lublin has received research support from Brainstorm. The institution of Dr. Lublin has received research support from biogen. The institution of Dr. Lublin has received research support from NIH.
Nancy M. Nealon, MD (Cornell Medical Center) Dr. Nealon has nothing to disclose.
Deepak J. Soneji, MD No disclosure on file
Kiersten M. Dykstra, PA, OT (UPMC) No disclosure on file
Zongqi Xia, MD, PhD The institution of Dr. Xia has received research support from National Institute of Health. The institution of Dr. Xia has received research support from Genentech/Roche.
Philip De Jager, MD, PhD (Columbia University Irving Medical Center) Dr. De Jager has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Puretech. Dr. De Jager has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for roche. Dr. De Jager has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for biogen. The institution of Dr. De Jager has received research support from roche. The institution of Dr. De Jager has received research support from puretech.
Claire Riley, MD, FÂ鶹´«Ã½Ó³»­ Dr. Riley has received personal compensation for serving as an employee of AstraZeneca. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic AG. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cabaletta Bio. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Riley has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Riley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics.