Do Early Relapses Predict the Risk of Long-Term Relapsing Disease in an Adult and Paediatric Cohort with MOGAD?
Chen B., Gomez-Figueroa E., Redenbaugh V., Francis A., Satukijchai C., Wu Y., Messina S., Sa M., Woodhall M., Robertson NP., Lim M., Wassmer E., Kneen R., Huda S., Blain C., Halfpenny C., Hemingway C., O'Sullivan E., Hobart J., Fisniku LK., Martin RJ., Dobson R., Cooper SA., Williams V., Waters P., Chen JJ., Pittock SJ., Ramdas S., Leite MI., Flanagan EP., Geraldes R., Palace J.
OBJECTIVE: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) can be monophasic or relapsing, with early relapse being a feature. However, the relevance of early relapse on longer-term relapse risk is unknown. Here, we investigate whether early relapses increase longer-term relapse risk in patients with MOGAD. METHODS: A retrospective analysis of 289 adult- and pediatric-onset patients with MOGAD followed for at least 2 years in 6 specialized referral centers. "Early relapses" were defined as attacks within the first 12 months from onset, with "very early relapses" defined within 30 to 90 days from onset and "delayed early relapses" defined within 90 to 365 days. "Long-term relapses" were defined as relapses beyond 12 months. Cox regression modeling and Kaplan-Meier survival analysis were used to estimate the long-term relapse risk and rate. RESULTS: Sixty-seven patients (23.2%) had early relapses with a median number of 1 event. Univariate analysis revealed an elevated risk for long-term relapses if any "early relapses" were present (hazard ratio [HR] = 2.11, p