[Chronic immunomodulatory treatment in MOGAD: Experience in Latin America]

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an autoimmune disorder of the central nervous system that predominantly affects children and young adults and presents a heterogeneous clinical spectrum. Disability in MOGAD is mainly associated with relapses. Treatment of MOGAD includes management of the acute episode and, in selected cases, the use of chronic immunomodulatory therapy to prevent relapses and sequelae. Currently, there are no therapeutic guidelines based on randomized clinical trials for MOGAD. Among the most commonly used options are oral immunosuppressants such as azathioprine and mycophenolate mofetil, intravenous immunoglobulin, rituximab, and, more recently, IL-6 pathway inhibitors such as tocilizumab. In Latin America, the management of MOGAD presents particular challenges related to access to high-cost therapies and the heterogeneity of healthcare systems.