Anti-MOG antibody–associated disorders: differences in clinical profiles and prognosis in Japan and Germany
Jia Liu, Masahiro Mori, Hanna Zimmermann, Alexander U. Brandt, Joachim Havla, Satoru Tanaka, Kazuo Sugimoto, Satoru Oji, Akiyuki Uzawa, Susanna Asseyer, Graham Cooper, Sven Jarius, Judith Bellmann–Strobl, Klemens Ruprecht, Nadja Siebert, Hiroki Masuda, Tomohiko Uchida, Ryohei Ohtani, Kyoichi Nomura, Edgar Meinl, Tania Kuempfel, Friedemann Paul, Satoshi Kuwabara
Abstract
Background Neurological disorders with IgG antibodies against myelin-oligodendrocyte glycoprotein (MOG-IgG) have been increasingly recognised as a new type of neuroinflammatory disorder. Objective The study aimed to identify regional and ethnic differences in clinical profiles of MOG-IgG–associated disorders between East Asian (Japanese) and Caucasian (German) patients. Methods Demographic, clinical and therapeutic data from 68 MOG-IgG–positive adults were collected (Japanese, n=44; German, n=24). Results Age and sex were similar between cohorts, with optic neuritis occurring most frequently at onset (Japanese: 61%; German: 58%). However, Japanese patients had a lower annualised relapse rate (0.4 vs 0.8, p=0.019; no relapse, 64% vs 25%, p=0.002) and lower Expanded Disability Status Scale score at the last visit (1.0 vs 2.0; p = 0.008), despite similar follow-up periods (mean, 73.9 months vs 73.4 months), than those of German patients, respectively. Cerebral syndromes were more common (27% vs 4%; p=0.021) and myelitis less common (21% vs 50%; p=0.012) in Japanese than in German patients, respectively. Japanese patients were more commonly treated with long-term corticosteroids (73%), whereas German patients were more commonly treated with rituximab or other immunosuppressants (63%). Conclusions Among patients with MOG-IgG, Japanese tended to have a monophasic milder disease, whereas the majority of German patients had a relapsing course and more frequent myelitis, findings compatible with neuromyelitis optica spectrum disorder. Although the attack-prevention treatment regimens were considerably different, genetic and environmental factors may be important to determine clinical phenotypes and disease activity.