Multiple sclerosis and related disorders · 2026
Relapse and disability across the disease course of MOGAD: a real-world cohort study from northern China.
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Cheng Peihang, Tian Suyan, Wang Zicheng, Luo Moyi, Dong Yuhan, Jin Tao
Аннотация
BACKGROUND: Relapse and long-term disability vary substantially in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), complicating remission-phase treatment decisions.
METHODS: We retrospectively included 120 consecutive MOGAD patients from northern China. Time to first relapse was analyzed using time-dependent Cox regression, recurrent relapses using episode-level time-dependent Cox models with cluster-robust standard errors, and final Expanded Disability Status Scale (EDSS) score ≥2.0 using logistic regression.
RESULTS: Fifty-three patients (44.2%) relapsed; among them, median time to first relapse was 267 days and 62.3% relapsed within 1 year. In first-attack analysis, corticosteroid maintenance ≥12 weeks (HR 0.32, 95% CI 0.16-0.65), older onset age per 10 years (HR 0.83, 95% CI 0.72-0.95), and higher cerebrospinal fluid leukocyte count (HR 1.29, 95% CI 1.01-1.64) were associated with relapse risk. In episode-level analysis, immunosuppressive therapy was associated with lower subsequent relapse risk (HR 0.27, 95% CI 0.10-0.76). At last follow-up, 50/119 patients (42.0%) had EDSS ≥2.0; older onset age (OR 2.02, 95% CI 1.44-2.84) and myelitis episode burden (OR 7.87, 95% CI 3.02-20.50) were independently associated with a final EDSS score ≥2.
CONCLUSIONS: Relapses were concentrated early and associated with remission-phase treatment exposure, whereas a final EDSS score ≥2 was associated mainly with older onset age and myelitis episode burden. Relapse prevention and disability prevention should be considered complementary but distinct goals in MOGAD management.
METHODS: We retrospectively included 120 consecutive MOGAD patients from northern China. Time to first relapse was analyzed using time-dependent Cox regression, recurrent relapses using episode-level time-dependent Cox models with cluster-robust standard errors, and final Expanded Disability Status Scale (EDSS) score ≥2.0 using logistic regression.
RESULTS: Fifty-three patients (44.2%) relapsed; among them, median time to first relapse was 267 days and 62.3% relapsed within 1 year. In first-attack analysis, corticosteroid maintenance ≥12 weeks (HR 0.32, 95% CI 0.16-0.65), older onset age per 10 years (HR 0.83, 95% CI 0.72-0.95), and higher cerebrospinal fluid leukocyte count (HR 1.29, 95% CI 1.01-1.64) were associated with relapse risk. In episode-level analysis, immunosuppressive therapy was associated with lower subsequent relapse risk (HR 0.27, 95% CI 0.10-0.76). At last follow-up, 50/119 patients (42.0%) had EDSS ≥2.0; older onset age (OR 2.02, 95% CI 1.44-2.84) and myelitis episode burden (OR 7.87, 95% CI 3.02-20.50) were independently associated with a final EDSS score ≥2.
CONCLUSIONS: Relapses were concentrated early and associated with remission-phase treatment exposure, whereas a final EDSS score ≥2 was associated mainly with older onset age and myelitis episode burden. Relapse prevention and disability prevention should be considered complementary but distinct goals in MOGAD management.