Do Early Relapses Predict the Risk of Long-Term Relapsing Disease in an Adult and Paediatric Cohort with MOGAD?
Correction(s) for this article
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Correction to “Do Early Relapses Predict the Risk of Long-Term Relapsing Disease in an Adult and Paediatric Cohort with MOGAD?”
- Volume 95Issue 3Annals of Neurology
- pages: 623-623
- First Published online: January 18, 2024
Bo Chen MD
Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK
Department of Neurology, Tongji Hospital of Tongji Medical College, Huazhong University of Science of Technology, Wuhan, China
Search for more papers by this authorEnrique Gomez-Figueroa MD
Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK
Department of Neurology, Civil Hospital of Guadalajara, University of Guadalajara, Guadalajara, Mexico
Search for more papers by this authorVyanka Redenbaugh MD
Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN
Search for more papers by this authorAnna Francis BMBCh
Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK
Search for more papers by this authorChanjira Satukijchai MD
Neuroscience Centre, Bangkok International Hospital, Bangkok, Thailand
Search for more papers by this authorYan Wu MD
Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, China
Search for more papers by this authorSilvia Messina MD
Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK
Neurology Department, Wexham Park Hospital, Frimley Foundation Health Trust, Slough, UK
Search for more papers by this authorMario Sa MD
Department of Paediatric Neurology, Oxford University NHS Foundation Trust, Oxford, UK
Search for more papers by this authorMark Woodhall PhD
Oxford Autoimmune Neurology Diagnostic Laboratory, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
Search for more papers by this authorFriedemann Paul MD
Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité Universitaetsmedizin Berlin, Germany
Search for more papers by this authorNeil P. Robertson MD
Department of Neurology, Division of Psychological Medicine and Clinical Neuroscience, Cardiff University, University Hospital of Wales, Cardiff, UK
Search for more papers by this authorMing Lim MD, PhD
Children's Neuroscience Centre, Evelina London Children's Hospital, London, UK
Women and Children's Department, Faculty of Life Sciences and Medicine, King's College London, London, UK
Search for more papers by this authorEvangeline Wassmer MD
Department of Paediatric Neurology, Birmingham Women and Children's Hospital, Birmingham, UK
Search for more papers by this authorRachel Kneen MD
Department of Paediatric Neurology, Alder Hey Children's NHS Foundation Trust and Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
Search for more papers by this authorSaif Huda MD, DPhil
Department of Neurology, Walton Centre NHS Foundation Trust, Liverpool, UK
Search for more papers by this authorCamilla Blain MD
Department of Neurology, St. George's University Hospitals National Health Service Foundation Trust, London, UK
Search for more papers by this authorChristopher Halfpenny PhD
Department of Neurology, Southampton General Hospital, Southampton, UK
Search for more papers by this authorCheryl Hemingway MD
Department of Paediatric Neurology, Great Ormond St. Hospital for Children, London, UK
Search for more papers by this authorEoin O'Sullivan MD
Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK
Search for more papers by this authorJeremy Hobart MD
Department of Neurology, University Hospitals Plymouth National Health Service Foundation Trust, Devon, UK
Search for more papers by this authorLeonora K. Fisniku PhD
Department of Neurosciences, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
Search for more papers by this authorRoswell J. Martin MD
Department of Neurology, Gloucestershire Hospitals National Health Service Foundation Trust, Gloucestershire, UK
Search for more papers by this authorRuth Dobson MD
Preventive Neurology Unit, Queen Mary University London, London, UK
Search for more papers by this authorSarah A. Cooper MD
Department of Neurology, University Hospitals Sussex National Health Service Foundation Trust, Brighton, UK
Search for more papers by this authorVictoria Williams MD
Department of Neurology, King's College Hospital NHS Foundation Trust, London, UK
Department of Neurology, Guy's and St. Thomas' National Health Service Foundation Trust, London, UK
Search for more papers by this authorPatrick Waters PhD
Oxford Autoimmune Neurology Diagnostic Laboratory, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
Search for more papers by this authorJohn J. Chen MD, PhD
Department of Ophthalmology and Neurology, Mayo Clinic, Rochester, MN
Search for more papers by this authorSean J. Pittock MD
Centre MS and Autoimmune Neurology, Department Neurology, Mayo Clinic, Rochester, MN
Search for more papers by this authorSithara Ramdas MD
MDUK Neuromuscular Centre, Department of Paediatrics, University of Oxford, Oxford, UK
Department of Paediatric Neurology, John Radcliffe Hospital, Oxford, UK
Search for more papers by this authorMaria Isabel Leite MD, PhD
Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK
Search for more papers by this authorEoin P. Flanagan MD
Departments of Neurology & Laboratory Medicine and Pathology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN
Search for more papers by this authorRuth Geraldes MD
Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK
Neurology Department, Wexham Park Hospital, Frimley Foundation Health Trust, Slough, UK
Search for more papers by this authorCorresponding Author
Jacqueline Palace MD
Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK
Address correspondence to Dr Palace, Department of Clinical Neurology, John Radcliffe Hospital, Oxford, OX3 9DU, UK. E-mail: [email protected]
Search for more papers by this authorBo Chen MD
Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK
Department of Neurology, Tongji Hospital of Tongji Medical College, Huazhong University of Science of Technology, Wuhan, China
Search for more papers by this authorEnrique Gomez-Figueroa MD
Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK
Department of Neurology, Civil Hospital of Guadalajara, University of Guadalajara, Guadalajara, Mexico
Search for more papers by this authorVyanka Redenbaugh MD
Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN
Search for more papers by this authorAnna Francis BMBCh
Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK
Search for more papers by this authorChanjira Satukijchai MD
Neuroscience Centre, Bangkok International Hospital, Bangkok, Thailand
Search for more papers by this authorYan Wu MD
Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, China
Search for more papers by this authorSilvia Messina MD
Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK
Neurology Department, Wexham Park Hospital, Frimley Foundation Health Trust, Slough, UK
Search for more papers by this authorMario Sa MD
Department of Paediatric Neurology, Oxford University NHS Foundation Trust, Oxford, UK
Search for more papers by this authorMark Woodhall PhD
Oxford Autoimmune Neurology Diagnostic Laboratory, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
Search for more papers by this authorFriedemann Paul MD
Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité Universitaetsmedizin Berlin, Germany
Search for more papers by this authorNeil P. Robertson MD
Department of Neurology, Division of Psychological Medicine and Clinical Neuroscience, Cardiff University, University Hospital of Wales, Cardiff, UK
Search for more papers by this authorMing Lim MD, PhD
Children's Neuroscience Centre, Evelina London Children's Hospital, London, UK
Women and Children's Department, Faculty of Life Sciences and Medicine, King's College London, London, UK
Search for more papers by this authorEvangeline Wassmer MD
Department of Paediatric Neurology, Birmingham Women and Children's Hospital, Birmingham, UK
Search for more papers by this authorRachel Kneen MD
Department of Paediatric Neurology, Alder Hey Children's NHS Foundation Trust and Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
Search for more papers by this authorSaif Huda MD, DPhil
Department of Neurology, Walton Centre NHS Foundation Trust, Liverpool, UK
Search for more papers by this authorCamilla Blain MD
Department of Neurology, St. George's University Hospitals National Health Service Foundation Trust, London, UK
Search for more papers by this authorChristopher Halfpenny PhD
Department of Neurology, Southampton General Hospital, Southampton, UK
Search for more papers by this authorCheryl Hemingway MD
Department of Paediatric Neurology, Great Ormond St. Hospital for Children, London, UK
Search for more papers by this authorEoin O'Sullivan MD
Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK
Search for more papers by this authorJeremy Hobart MD
Department of Neurology, University Hospitals Plymouth National Health Service Foundation Trust, Devon, UK
Search for more papers by this authorLeonora K. Fisniku PhD
Department of Neurosciences, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
Search for more papers by this authorRoswell J. Martin MD
Department of Neurology, Gloucestershire Hospitals National Health Service Foundation Trust, Gloucestershire, UK
Search for more papers by this authorRuth Dobson MD
Preventive Neurology Unit, Queen Mary University London, London, UK
Search for more papers by this authorSarah A. Cooper MD
Department of Neurology, University Hospitals Sussex National Health Service Foundation Trust, Brighton, UK
Search for more papers by this authorVictoria Williams MD
Department of Neurology, King's College Hospital NHS Foundation Trust, London, UK
Department of Neurology, Guy's and St. Thomas' National Health Service Foundation Trust, London, UK
Search for more papers by this authorPatrick Waters PhD
Oxford Autoimmune Neurology Diagnostic Laboratory, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
Search for more papers by this authorJohn J. Chen MD, PhD
Department of Ophthalmology and Neurology, Mayo Clinic, Rochester, MN
Search for more papers by this authorSean J. Pittock MD
Centre MS and Autoimmune Neurology, Department Neurology, Mayo Clinic, Rochester, MN
Search for more papers by this authorSithara Ramdas MD
MDUK Neuromuscular Centre, Department of Paediatrics, University of Oxford, Oxford, UK
Department of Paediatric Neurology, John Radcliffe Hospital, Oxford, UK
Search for more papers by this authorMaria Isabel Leite MD, PhD
Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK
Search for more papers by this authorEoin P. Flanagan MD
Departments of Neurology & Laboratory Medicine and Pathology and Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN
Search for more papers by this authorRuth Geraldes MD
Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK
Neurology Department, Wexham Park Hospital, Frimley Foundation Health Trust, Slough, UK
Search for more papers by this authorCorresponding Author
Jacqueline Palace MD
Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UK
Address correspondence to Dr Palace, Department of Clinical Neurology, John Radcliffe Hospital, Oxford, OX3 9DU, UK. E-mail: [email protected]
Search for more papers by this authorEnrique Gomez-Figueroa, Vyanka Redenbaugh, Anna Francis, Eoin P. Flanagan and Ruth Geraldes contributed equally to this work.
[Correction added on January 3, 2024, after first online publication: Friedemann Paul was added to the author list.]
Abstract
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;94:508–517
Potential Conflicts of Interest
None relevant to this work.
Open Research
Data Availability Statement
The data herein are unavailable publicly due to restricted access, but some information about the data sets is available from the corresponding author upon reasonable request.
Supporting Information
Filename | Description |
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ana26731-sup-0001-FigureS1.tifTIFF image, 517.5 KB | Figure S1: Patient distribution by corticosteroid treatment duration. |
ana26731-sup-0002-FigureS2.tifTIFF image, 75.3 KB | Figure S2: Kaplan–Meier analysis of 160 patients with onset in the last 10 years (since 2013). |
ana26731-sup-0003-FigureS3.tifTIFF image, 66.3 KB | Figure S3: Kaplan–Meier analysis of 69 patients with “brain” phenotype at onset. |
ana26731-sup-0004-FigureS4.tifTIFF image, 71.4 KB | Figure S4: Kaplan–Meier analysis of 220 patients with non- “brain” phenotype at onset. |
ana26731-sup-0005-TableS1.docxWord 2007 document , 15.5 KB | Table S1. Age-associated phenotypes. |
ana26731-sup-0006-TableS2.docxWord 2007 document , 19.3 KB | Table S2: Long-term relapse risk of different phenotypes. |
ana26731-sup-0007-TableS3.docxWord 2007 document , 17.4 KB | Table S3: The effect of very early relapse on long-term relapse risk in adult- and pediatric-onset patients with different phenotypes. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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