MOG-IgG Associated Disease (MOG-AD) in Adults

AbstractPurpose of reviewThis review offers a look into available treatment strategies for patients with MOG-IgG associated disease (MOG-AD). We will focus on evidence-based management options in the acute setting. We will also present recommendations for initiation of long-term immunotherapy for patients with a relapsing course and discuss our approach for monitoring disease progression and escalation of therapy.Recent findingsAs commercial testing for MOG-IgG did not become widely available until 2016, most of the evidence concerning management is from retrospective observational studies. Acutely, 1  g daily of intravenous methylprednisolone (IVMP) for 3–5 days has been associated with better outcomes for optic neuritis. This is typically followed by a prolonged oral prednisone taper. Long-term immunotherapy is reserved for patients with relapsing or severely disabling disease. There are ye t to be any prospective trials for selection of the most appropriate agent. Rituximab, azathioprine, mycophenolate mofetil, and IVIG have all been used. Disease-modifying therapies (DMTs) typically used for multiple sclerosis (MS) are avoided.SummaryIVMP followed by a prolonged prednisone taper is the mainstay of acute management. However, there is limited consensus on the best long-term immunotherapy and prospective studies are needed to compare the efficacy of different agents. The development of targeted therapies is expected in the future as the pathogenesis of MOG-IgG becomes be...
Source: Current Treatment Options in Neurology - Category: Neurology Source Type: research