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Do Early Relapses Predict the Risk of Long-Term Relapsing Disease in an Adult and Paediatric Cohort with MOGAD?

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单位： [1]Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK [2]Department of Neurology, Tongji Hospital of TongjiMedical College, Huazhong University of Science of Technology, Wuhan, China [3]Department of Neurology, Civil Hospital of Guadalajara, University ofGuadalajara, Guadalajara, Mexico [4]Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN [5]Neuroscience Centre, BangkokInternational Hospital, Bangkok, Thailand [6]Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, China [7]NeurologyDepartment, Wexham Park Hospital, Frimley Foundation Health Trust, Slough, UK [8]Department of Paediatric Neurology, Oxford University NHSFoundation Trust, Oxford, UK [9]Oxford Autoimmune Neurology Diagnostic Laboratory, Nuffield Department of Clinical Neurosciences, University ofOxford, Oxford, UK [10]Department of Neurology, Division of Psychological Medicine and Clinical Neuroscience, Cardiff University, University Hospital ofWales, Cardiff, UK [11]Children’s Neuroscience Centre, Evelina London Children’s Hospital, London, UK [12]Women and Children’s Department, Faculty ofLife Sciences and Medicine, King’s College London, London, UK [13]Department of Paediatric Neurology, Birmingham Women and Children’s Hospital,Birmingham, UK [14]Department of Paediatric Neurology, Alder Hey Children’s NHS Foundation Trust and Institute of Infection, Veterinary and EcologicalSciences, University of Liverpool, Liverpool, UK [15]Department of Neurology, Walton Centre NHS Foundation Trust, Liverpool, UK [16]Department ofNeurology, St. George’s University Hospitals National Health Service Foundation Trust, London, UK [17]Department of Neurology, Southampton GeneralHospital, Southampton, UK [18]Department of Paediatric Neurology, Great Ormond St. Hospital for Children, London, UK [19]Department ofOphthalmology, King’s College Hospital NHS Foundation Trust, London, UK [20]Department of Neurology, University Hospitals Plymouth National HealthService Foundation Trust, Devon, UK [21]Department of Neurosciences, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK [22]Department of Neurology, Gloucestershire Hospitals National Health Service Foundation Trust, Gloucestershire, UK [23]Preventive Neurology Unit,Queen Mary University London, London, UK [24]Department of Neurology, University Hospitals Sussex National Health Service Foundation Trust, Brighton,UK [25]Department of Neurology, King’s College Hospital NHS Foundation Trust, London, UK [26]Department of Neurology, Guy’s and St. Thomas’ NationalHealth Service Foundation Trust, London, UK [27]Department of Ophthalmology and Neurology, Mayo Clinic, Rochester, MN [28]Centre MS andAutoimmune Neurology, Department Neurology, Mayo Clinic, Rochester, MN [29]MDUK Neuromuscular Centre, Department of Paediatrics, University ofOxford, Oxford, UK [30]Department of Paediatric Neurology, John Radcliffe Hospital, Oxford, UK [31]Departments of Neurology & Laboratory Medicineand Pathology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN

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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 < 0.001), whether occurring during the first 3 months (HR = 2.70, p < 0.001) or the remaining 9 months (HR = 1.88, p = 0.001), with similar results yielded in the multivariate analysis. In children with onset below aged 12 years, only delayed early relapses were associated with an increased risk of long-term relapses (HR = 2.64, p = 0.026).Interpretation: The presence of very early relapses and delayed early relapses within 12 months of onset in patients with MOGAD increases the risk of long-term relapsing disease, whereas a relapse within 90 days appears not to indicate a chronic inflammatory process in young pediatric-onset disease. ANN NEUROL 2023;00:1-10

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出版当年[2022]版：

大类 | 1 区

医学

小类 | 1 区神经科学 1 区临床神经病学

最新[2025]版：

大类 | 1 区

医学

小类 | 1 区临床神经病学 1 区神经科学

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出版当年[2021]版：

Q1 CLINICAL NEUROLOGY Q1 NEUROSCIENCES

最新[2023]版：

Q1 CLINICAL NEUROLOGY Q1 NEUROSCIENCES

影响因子： 8.1 最新[2023版] 9.9 最新五年平均 11.274 出版当年[2021版] 12.344 出版当年五年平均 10.422 出版前一年[2020版] 11.2 出版后一年[2022版]

第一作者：

第一作者单位： [1]Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK [2]Department of Neurology, Tongji Hospital of TongjiMedical College, Huazhong University of Science of Technology, Wuhan, China

通讯作者：

通讯机构： [1]Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK [*1]Department of Clinical Neurology, John Radcliffe Hospital, Oxford, OX3 9DU, UK.

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