Early treatment of the first acute myelin oligodendrocyte glycoprotein antibody–associated disease attack may be associated with a reduced relapse risk and an increased likelihood of seronegative conversion, according to a new study.
The nationwide cohort study, published in JAMA Neurology, evaluated the impact of time to treatment on the disease course of myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD). The retrospective analysis included 240 adult patients who experienced their first acute MOGAD attack. Patients were categorized into three groups based on the timing of their treatment initiation: early (< 5 days), intermediate (5-14 days), and late (> 14 days).
In the study, 45.8% of patients experienced relapse, with the median time to relapse being 0.45 years (interquartile range = 0.18–1.68 years). Twenty-five percent of patients achieved myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG) seronegative status during the follow-up period.
Results also showed that earlier treatment was associated with a lower risk of disease relapse and an increased likelihood of seronegative conversion of anti–MOG-IgG. Patients in the early treatment group had a 2.64-fold lower risk of relapse compared to those treated late (adjusted hazard ratio [aHR] = 2.64; 95% confidence interval [CI] = 1.43-4.84; P = .002) and were 7.04 times more likely to achieve MOG-IgG seronegative status—a statistically significant association (adjusted odds ratio [aOR] = 7.04; 95% CI = 1.58-31.41; P = .01).
Patients who received late treatment had a 2.64 times higher risk of relapse compared to those who received early treatment (aHR = 2.64; 95% CI = 1.43-4.84; P = .002). Those treated in the intermediate period had a 2.02 times higher risk of relapse compared to those who received early treatment (aHR = 2.02; 95% CI = 1.10-3.74; P = .02). In the subgroup of patients who did not receive long-term nonsteroidal immunosuppressant (NSIS) therapy, the risk of relapse was 3.51 times higher for late treatment compared to early treatment (aHR = 3.51; 95% CI = 1.64-7.50; P = .001), and 2.68 times higher for intermediate treatment compared to early treatment (aHR, 2.68; 95% CI, 1.23-5.85; P = .01). Patients who received early treatment were 7.04 times more likely to achieve seronegative conversion compared to those who received late treatment (aOR = 7.04; 95% CI = 1.58-31.41; P = .01). Patients treated in the intermediate period had a 2.85 times higher likelihood of seronegative conversion compared to late treatment; however, this association was not statistically significant (aOR = 2.85; 95% CI = 0.72-11.37; P = .14).
Full disclosures can be found in the published study.