Clinical Features and Factors Associated With Outcome in Late Adult-Onset Myelin Oligodendrocyte Glycoprotein Antibody–Associated Disease
Alessandro Dinoto, Laura Cacciaguerra, Nisa Vorasoot, Vyanka Redenbaugh, A. Sebastian López‐Chiriboga, Cristina Valencia-Sánchez, Kai Guo, Smathorn Thakolwiboon, Susan E. Horsman, Stephanie B. Syc‐Mazurek, Nanthaya Tisavipat, Jayawant N. Mandrekar, Deena Tajfirouz, Eric Eggenberger, Misha Pless, Kevin D. Chodnicki, Jan-Mendelt Tillema, Sean J. Pittock, John J. Chen, Eoin P. Flanagan
Abstract
BACKGROUND AND OBJECTIVES: Data regarding late adult-onset myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are scant. This study sought to assess the frequency, characteristics, and outcome of late adult-onset MOGAD and identify differences from early adult-onset MOGAD. METHODS: This retrospective, observational study included Mayo Clinic patients with MOGAD per 2023 diagnostic criteria and with onset age 50 years or older. Clinical, laboratory, radiologic, treatment, and outcome data were collected and compared between patients aged 50-59 years and those aged 60 years or older. Finally, the characteristics and outcome of patients with late adult-onset MOGAD (aged 50 or older) were compared with a reference group of patients with early adult-onset (aged 18-49) MOGAD (n = 141). RESULTS: < 0.001; OR: 0.4; 95% CI 0.2-0.7) vs those with early adult-onset MOGAD, but EDSS scores and frequency of a relapsing course were similar. DISCUSSION: Late adult-onset MOGAD accounts for one-quarter of patients with MOGAD. Optic neuritis is the dominant phenotype in this age group with MOGAD and is under-recognized and frequently misdiagnosed. Outcomes in late adult-onset MOGAD are similar to those in early adult-onset disease.