Disability and Relapse Risk in Late-Onset Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ju Hyunjin, Kim Ki Hoon, Woo Sook Young, Chung Yeon Hak, Kim Ho Jin, Kim Hyunjin, Lee Eun-Jae, Lim Young-Min, Ju Woohee, Kim Sung-Min, Kwon Young Nam, Kim Seung Woo, Shin Ha Young, Joo In Soo, Kim Sohyeon, Seok Hung Youl, Bong Jeong Bin, Yoon Byeol-A, Kim Jong Kuk, Kang You-Ri, Nam Tai-Seung, Kim Sooyoung, Sohn Eunhee, Kim Woojun, Seok Jin Myoung, Lee Hyung-Soo, Oh Sun-Young, Ahn Suk-Won, Lee Sukyoon, Lee Tae-Kyeong, Lee Hye Lim, Kim Nam-Hee, Oh Jeeyoung, Kim Jee-Eun, Kwon Soonwook, Oh Seong-Il, Park Min Su, Bae Jong Seok, Kim Wookyung, Park Jin-Woo, Kim Byung-Jo, Yang Jiwon, Kim Su-Hyun, Min Ju-Hong
Аннотация
OBJECTIVE: To investigate the association of late onset MOGAD with moderate disability and relapse in Korean patients.
DESIGN, SETTING, AND PARTICIPANTS: This nationwide, multicenter, retrospective cohort study included adult patients with a diagnosis of MOGAD according to the 2023 international diagnostic criteria between August 2018 and September 2024 across 28 hospitals in South Korea.
EXPOSURE: Age at onset of MOGAD, categorized into adult-onset MOGAD (AO-MOGAD; 18-49 years) and late-onset MOGAD (LO-MOGAD; ≥50 years).
MAIN OUTCOMES AND MEASURES: The primary outcomes were time to first relapse in patients with a disease duration of 12 or more months and moderate disability, defined as Expanded Disability Status Scale (EDSS) score of 3 or greater at last follow-up.
RESULTS: A total of 350 patients (mean [SD] age at onset, 43.2 [15.0] years; 189 female [54.0%]) with a median (IQR) baseline EDSS of 3.0 (2.0-4.0) were included, with 124 patients (35.4%) with LO-MOGAD and 226 patients (64.6%) with AO-MOGAD. The LO-MOGAD group had less frequent brain involvement than the AO-MOGAD group at onset (26 patients [21.0%] vs 75 patients [33.2%]; P = .02) and during the disease course (28 patients [22.6%] vs 95 patients [42.0%]; P < .001), while optic neuritis or myelitis was comparable between the 2 groups. The LO-MOGAD group showed more frequent monophasic course (55 of 95 patients [57.9%] vs 75 of 188 patients [39.9%]; P = .004), but higher EDSS score at last follow-up (median [IQR], 2.0 [1.0-2.0] vs 1.0 [0.0-2.0]; P < .001) compared with those in the AO-MOGAD group. However, late onset was not significantly associated with the time to first relapse in multivariable analysis (adjusted hazard ratio, 0.72; 95% CI, 0.48-1.08; P = .11), which was consistent after propensity score matching. By contrast, late onset was associated with a significantly higher risk of moderate disability at the last follow-up (adjusted odds ratio, 2.84; 95% CI, 1.39-5.80; P = .004).
CONCLUSIONS AND RELEVANCE: In this cohort study of MOGAD, late onset was not associated with a risk of relapse but with a higher risk of moderate disability at follow-up. Prospective studies with longer follow-up periods are warranted to better understand and manage patients with late-onset disease.