Abstract Details

Title Age and Sex Distributions of MOG-IgG and AQP4-IgG Positive Sera from a Large Neuroimmunology Laboratory Database

Topic General Neurology

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 6-028

Objective

To determine the age and sex distribution of Myelin oligodendrocyte glycoprotein (MOG)-IgG seropositive and aquaporin-4 (AQP4)-IgG seropositive patients versus those testing negative.

Background

MOG-IgG is a biomarker of MOG-antibody-associated-disease (MOGAD), a distinct central nervous system demyelinating disease with overlapping clinical features with AQP4-IgG-seropositive-neuromyelitis-optica-spectrum-disorders (AQP4+NMOSD). Knowledge of age and sex distribution from large cohorts tested for MOG-IgG and AQP4-IgG can provide useful epidemiology data to guide allocation of resources and healthcare delivery.

Design/Methods

This is a retrospective laboratory-based study utilizing the Mayo Clinic neuroimmunology laboratory data on serum testing of MOG-IgG with live cell-based assay (2017-2022) and AQP4-IgG with fixed or live cell-based assay (2007-2021). Age, sex, and antibody titers were evaluated.

Results

Of 96,373 patients’ sera tested for MOG-IgG, 7,367 (7.6%) were positive. Patients seropositive for MOG-IgG were younger than MOG-IgG seronegative patients (median age 34 [IQR 17-49] vs 42 [30-55] years, respectively; p<0.001). Among MOG-IgG seropositive patients, 1,167 (15.8%) were pediatric (aged <12 years), and 735 (10%) 12-17 years and 475 (6.5%) were elderly (aged ≥65 years). MOG-IgG seropositives had a female-to-male ratio of 1.6:1 while MOG-IgG seronegatives had a ratio of 2:1. The median MOG-IgG titer was 1:100 (IQR 1:40-1:100). Higher serum titers (≥1:1,000) were most frequent in pediatrics (42.8%) versus other groups (p<0.001).

Of 145,418 patients’ sera tested for AQP4-IgG, 5,505 (3.8%) were positive. The median age of AQP4-IgG seropositive and seronegative patients was 48 (IQR 33-60) and 42 (IQR 30-54) years, respectively; p<0.001. The female-to-male ratio in AQP4-IgG seropositives was 6.5:1 and greater than AQP4-IgG seronegatives (2:1) (p<0.001). The median AQP4-IgG serum titer was 1:1,000 (IQR 1:100-1:10,000).

Conclusions

This large dataset shows the predilection of pediatric patients for both MOG-IgG positivity and higher titers while also revealing a slight female predominance. In comparison, AQP4-IgG positives were older and had a higher proportion of females.

Authors/Disclosures
Nisa Vorasoot, MD PRESENTER	Dr. Vorasoot has nothing to disclose.
Amy Kunchok, MBBS (Cleveland Clinic - Mellen Centre)	Dr. Kunchok has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology:Open Access Journal .
	No disclosure on file
Jennifer McCombe, MD (University of Alberta)	Dr. McCombe has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon therapeutics. Dr. McCombe has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. McCombe has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. McCombe has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Horizon therapeutics.
Vyanka Redenbaugh, MB BCh BAO (Mayo Clinic)	Dr. Redenbaugh has nothing to disclose.
Laura Cacciaguerra, MD, PhD (Mayo Clinic)	Dr. Cacciaguerra has nothing to disclose.
Smathorn Thakolwiboon, MD (Mayo Clinic Health System)	Dr. Thakolwiboon has nothing to disclose.
Nanthaya Tisavipat, MD (Mayo Clinic)	Miss Tisavipat has nothing to disclose.
Yahya J. Abdulrahman	Mr. Abdulrahman has nothing to disclose.
John Chen	John Chen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. John Chen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. John Chen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB.
Sean J. Pittock, MD, FAAN (Mayo Clinic Dept of Neurology)	Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arialys. The institution of Dr. Pittock has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. The institution of Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. The institution of Dr. Pittock has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche/Genentech. The institution of Dr. Pittock has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion/AstraZeneka. The institution of Dr. Pittock has received research support from NIH. Dr. Pittock has received intellectual property interests from a discovery or technology relating to health care. Dr. Pittock has received intellectual property interests from a discovery or technology relating to health care. Dr. Pittock has received publishing royalties from a publication relating to health care.
Eoin P. Flanagan, MBBCh, FAAN (Mayo Clinic)	The institution of Dr. Flanagan has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Flanagan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Pharmacy times. The institution of Dr. Flanagan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for UCB. The institution of Dr. Flanagan has received research support from UCB. The institution of Dr. Flanagan has received research support from Roche. The institution of Dr. Flanagan has received research support from UCB. The institution of Dr. Flanagan has received research support from Merck. The institution of Dr. Flanagan has received research support from Roche. Dr. Flanagan has received publishing royalties from a publication relating to health care. Dr. Flanagan has received publishing royalties from a publication relating to health care. Dr. Flanagan has a non-compensated relationship as a Member of medical Advisory Board with The MOG Project that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial board member with Journal of The Neurologic Sciences that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial board member with Neuroimmunology Reports that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial Board Member with Neurology, Neuroimmunology Neuroinflammation (N2) Journal that is relevant to AAN interests or activities. Dr. Flanagan has a non-compensated relationship as a Editorial Board Member with Neurology that is relevant to AAN interests or activities.

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