Myelin Oligodendrocyte Glycoprotein Antibodies in Adults with a First Demyelinating Event Suggestive of Multiple Sclerosis

Javier Villacieros-Álvarez; Carmen Espejo; Georgina Arrambide; Mireia Castillo; Pere Carbonell-Mirabent; Marta Rodriguez; Luca Bollo; Joaquín Castilló; Manuel Comabella; Ingrid Galán; Luciana Midaglia; Neus Mongay-Ochoa; Carlos Nos; Jordi Rio; Breogan Rodríguez-Acevedo; Jaume Sastre-Garriga; Carmen Tur; Angela Vidal-Jordana; Andreu Vilaseca; Ana Zabalza; Cristina Auger; Alex Rovira; Xavier Montalban; Mar Tintoré; Álvaro Cobo-Calvo

doi:10.1002/ana.26793

Myelin Oligodendrocyte Glycoprotein Antibodies in Adults with a First Demyelinating Event Suggestive of Multiple Sclerosis

Ann Neurol. 2023 Sep 14. doi: 10.1002/ana.26793. Online ahead of print.

Authors

Javier Villacieros-Álvarez^{1

2}, Carmen Espejo^{1

2}, Georgina Arrambide^{1

2}, Mireia Castillo^{1

2}, Pere Carbonell-Mirabent^{1

2}, Marta Rodriguez^{1

2}, Luca Bollo^{1

2}, Joaquín Castilló^{1

2}, Manuel Comabella^{1

2}, Ingrid Galán^{1

2}, Luciana Midaglia^{1

2}, Neus Mongay-Ochoa^{1

2}, Carlos Nos^{1

2}, Jordi Rio^{1

2}, Breogan Rodríguez-Acevedo^{1

2}, Jaume Sastre-Garriga^{1

2}, Carmen Tur^{1

2}, Angela Vidal-Jordana^{1

2}, Andreu Vilaseca^{1

2}, Ana Zabalza^{1

2}, Cristina Auger^{2

3}, Alex Rovira^{2

3}, Xavier Montalban^{1

2}, Mar Tintoré^{1

2}, Álvaro Cobo-Calvo^{1

2}

Affiliations

¹ Neurology-Neuroimmunology Department, Multiple Sclerosis Center of Catalonia, Vall d'Hebron Barcelona Hospital Campus, Vall d'Hebron Research Institute, Barcelona, Spain.
² Autonomous University of Barcelona, Barcelona, Spain.
³ Section of Neuroradiology, Vall d'Hebron University Hospital, Barcelona, Spain.

PMID: 37705507
DOI: 10.1002/ana.26793

Abstract

Objective: Myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) distinguish multiple sclerosis (MS) from MOG-associated disease in most cases. However, studies analyzing MOG-Ab at the time of a first demyelinating event suggestive of MS in adults are lacking. We aimed to (1) evaluate the prevalence of MOG-Ab in a first demyelinating event suggestive of MS and (2) compare clinical and paraclinical features between seropositive (MOG-Ab+) and seronegative (MOG-Ab-) patients.

Methods: Six hundred thirty adult patients with available serum samples obtained within 6 months from the first event were included. MOG-Ab were analyzed using a live cell-based assay. Statistical analyses included parametric and nonparametric tests, logistic regression, and survival models.

Results: MOG-Ab were positive in 17 of 630 (2.7%). Fourteen out of 17 (82.4%) MOG-Ab+ patients presented with optic neuritis (ON) compared to 227of 613 (37.0%) MOG-Ab- patients (p = 0.009). Cerebrospinal fluid-restricted oligoclonal bands (CSF-OBs) were found in 2 of 16 (12.5%) MOG-Ab+ versus 371 of 601 (61.7%) MOG-Ab- subjects (p < 0.001). Baseline brain magnetic resonance imaging (MRI) was normal in 9 of 17 (52.9%) MOG-Ab+ versus 153 of 585 (26.2%) MOG-Ab- patients (p = 0.029). Absence of CSF-OBs and ON at onset were independently associated with MOG-Ab positivity (odds ratio [OR] = 9.03, 95% confidence interval [CI] = 2.04-53.6, p = 0.009; and OR = 4.17, 95% CI = 1.15-19.8, p = 0.042, respectively). Of MOG-Ab+ patients, 22.9% (95% CI = 0.0-42.7) compared to 67.6% (95% CI = 63.3-71.3) of MOG-Ab- patients fulfilled McDonald 2017 criteria at 5 years (log-rank p = 0.003).

Interpretation: MOG-Ab are infrequent in adults with a first demyelinating event suggestive of MS. However, based on our results, we suggest to determine these antibodies in those patients with ON and absence of CSF-OBs, as long as the brain MRI is not suggestive of MS. ANN NEUROL 2023.

Abstract

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