Emerging Principles for Treating Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD)

Area of Science:

• Neuroimmunology
• Central Nervous System Disorders

Background:

• Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare inflammatory central nervous system disorder impacting adults and children.
• Neurologic disability in MOGAD is relapse-driven, necessitating early diagnosis and targeted treatment.

Purpose of the Study:

• To review the newly established diagnostic criteria for MOGAD.
• To examine current evidence for acute and preventative therapies for MOGAD.

Main Methods:

• Review of the first clinical, laboratory, and radiographic criteria for MOGAD diagnosis by the International MOGAD Panel.
• Evaluation of retrospective studies on off-label agents for MOGAD acute care and prevention.
• Consideration of ongoing prospective randomized clinical trials.

Main Results:

• New diagnostic criteria provide a foundation for clinical investigations and future trials.
• Acute MOGAD attacks often respond to high-dose corticosteroids; plasma exchange or IVIG may aid severe or refractory cases.
• Slow corticosteroid tapering can reduce relapse risk; preventative therapies are mainly for relapsing disease.

Conclusions:

• Emerging therapies like IL-6 receptor and neonatal Fc receptor inhibition show promise for MOGAD treatment.
• The development of standardized criteria and ongoing trials are advancing MOGAD patient care.