Abstract Details

Title Conformational PLP-1 Antibodies as a Prognostic Biomarker in MOGAD

Topic Autoimmune Neurology

Presentation(s) S6 - Autoimmune Neurology: NMOSD and MOGAD (2:48 PM-3:00 PM)

Poster/Presentation
Number 010

Objective We aimed to assess the potential of Proteolipid Protein 1 (PLP1)-IgG as a prognostic biomarker in a large multicentric MOGAD cohort.

Background

Conformational antibodies to PLP1 have been found in a subset of MOGAD patients, who present with a more aggressive disease onset.

Design/Methods We included 127 consecutive MOGAD patients from 13 centres, with serum samples available within three months of disease diagnosis and a 12 month-minimum follow-up. PLP1-IgG were assessed with an in-house live cell-based assay and reported as positive with a 1:40 titre. Demographical, clinical, paraclinical features and disability outcomes were compared among PLP1+ and PLP1- MOGAD patients. Incomplete recovery from the presenting attack was defined as an mRS or EDSS ≥ 2 at discharge after acute phase treatment. Multivariate logistic regression was performed to identify independent predictors of incomplete recovery. Time to first relapse was analyzed using Cox proportional hazards regression with serostatus stratification.

Results PLP1-IgG were found in 16% of patients (20/127), more frequently within adults rather than children (23% vs 10%). Despite similar clinical severity at disease acme (EDSS and mRS: p=0.92; p=0.86), PLP1+ MOGAD patients showed a higher rate of incomplete inaugural attack recovery (12/20 vs. 32/107, p<0.001). Disability measures at discharge were significantly higher in PLP1+ patients (median EDSS 2.0 vs 1.0, p<0.01; median mRS 1.0 vs 0.0, p<0.001)
PLP1 positivity was the only significant predictor of incomplete recovery in the multivariate logistic regression model (OR 3.89 [CI 1.36 – 11.76]), whereas motor symptoms, baseline EDSS, and mRS showed no significant association. PLP1+ MOGAD patients had a significantly shorter time to first relapse compared to PLP1– (Cox Hazard Ratio 2.44 [CI 1.11 – 5.35], p=0.026).

Conclusions PLP1 antibodies identify a high-risk subgroup of MOGAD patients with residual disability after the first attack and a higher predisposition to a relapsing course.

Authors/Disclosures
Matteo Gastaldi, MD, PhD (IRCCS Mondino Foundation) PRESENTER	Dr. Gastaldi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for alexion, Roche, UCB, J&J. The institution of Dr. Gastaldi has received research support from Italian Ministry of Health, FISM, AE alliance.
Giacomo Greco	Giacomo Greco has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Giacomo Greco has received personal compensation in the range of $0-$499 for serving as a Consultant for Amgen. Giacomo Greco has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Giacomo Greco has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis.
Stefano Masciocchi, MD	Dr. Masciocchi has nothing to disclose.
Pietro Businaro	Pietro Businaro has nothing to disclose.
Federica Zuliani, PhD	Mrs. Zuliani has nothing to disclose.
Margherita Vacca, MSc	Ms. Vacca has nothing to disclose.
Chiara Morandi, Biologist	Dr. Morandi has nothing to disclose.
Eleonora Rigoni, MD	Dr. Rigoni has nothing to disclose.
Giorgia Bruno, MD	Dr. Bruno has nothing to disclose.
Sara Carta, MD (Neurology Unit, University of Verona)	An immediate family member of Dr. Carta has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB . The institution of Dr. Carta has received research support from MEDEN.
Mario Risi, MD	Dr. Risi has nothing to disclose.
Manuela Lo Bianco, MD	Dr. Lo Bianco has nothing to disclose.
antonio covelli, MD	Dr. covelli has nothing to disclose.
Giulia Cellante (University of Udine)	No disclosure on file
Silvia Sperandei, MD	Dr. Sperandei has nothing to disclose.
Alessandro Santagostino Barbone, MD	Dr. Santagostino Barbone has nothing to disclose.
Thomas Foiadelli, MD, PhD	Dr. Foiadelli has nothing to disclose.
Alvino Bisecco	Alvino Bisecco has nothing to disclose.
Erica Curti, MD	Dr. Curti has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Curti has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis . Dr. Curti has received publishing royalties from a publication relating to health care. Dr. Curti has received personal compensation in the range of $500-$4,999 for serving as a Speaker at scientific events with Bristol Myers Squibb. Dr. Curti has received personal compensation in the range of $500-$4,999 for serving as a Speaker at scientific events with Alexion. Dr. Curti has received personal compensation in the range of $500-$4,999 for serving as a Speaker at scientific events with Roche. Dr. Curti has received personal compensation in the range of $500-$4,999 for serving as a Travel fees for scientific events with Roche. Dr. Curti has received personal compensation in the range of $500-$4,999 for serving as a Travel fees for scientific events with Novartis.
Emanuela Claudia Turco (Parma University Hospital)	No disclosure on file
Antonio Gallo	Antonio Gallo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Antonio Gallo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Antonio Gallo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Antonio Gallo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis.
Chiara Rocchi, MD	The institution of Dr. Rocchi has received research support from Ectrims.
Saif Huda, MD (NHS)	Dr. Huda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen.
Margherita Mancardi (University of Genova)	No disclosure on file
Massimiliano Di Filippo, MD	No disclosure on file
Martina Fabris, MD	Prof. Fabris has nothing to disclose.
Alberto Vogrig, MD, PhD (University of Udine)	Dr. Vogrig has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Eisai. Dr. Vogrig has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Angelini. The institution of Dr. Vogrig has received research support from Ministero della Salute, Bando Ricerca Finalizzata.
Simone Vidale, MD	Dr. Vidale has nothing to disclose.
Martino Ruggieri (University of Catania)	No disclosure on file
Antonio Varone (Santobono-Pausilipon Children’s Hospital)	No disclosure on file
Sara Mariotto, MD, PhD (Neurology Unit, University of Verona)	Dr. Mariotto has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen, Sanofi, Alexion, Roche, TSF, Dynamics, UCB, Novartis, Amgen, AAN. The institution of Dr. Mariotto has received research support from Ministero della Salute Italiano. The institution of Dr. Mariotto has received research support from TSF. The institution of Dr. Mariotto has received research support from GJF. The institution of Dr. Mariotto has received research support from Lundbeck. The institution of Dr. Mariotto has received research support from Euroimmun. The institution of Dr. Mariotto has received research support from FISM.
Georgina Arrambide, MD, PhD (Cemcat, Vall d´Hebron University Hospital)	The institution of Dr. Arrambide has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Arrambide has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Platform Adaptive Trial for remyelination and neuroprotection in mUltiple Sclerosis (PLATYPUS) . The institution of Dr. Arrambide has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. The institution of Dr. Arrambide has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb. Dr. Arrambide has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Sage. The institution of Dr. Arrambide has received research support from Instituto de Salud Carlos III. Dr. Arrambide has received personal compensation in the range of $500-$4,999 for serving as a Travel support for scientific meetings with Novartis. Dr. Arrambide has received personal compensation in the range of $500-$4,999 for serving as a Travel support for scientific meetings with Roche. Dr. Arrambide has received personal compensation in the range of $500-$4,999 for serving as a Travel support for scientific meetings with ECTRIMS. Dr. Arrambide has received personal compensation in the range of $500-$4,999 for serving as a Travel support for scientific meetings with EAN. Dr. Arrambide has a non-compensated relationship as a Member of the Executive Committee with iWiMS that is relevant to AAN interests or activities. Dr. Arrambide has a non-compensated relationship as a Member of the steering committee with BioMS-eu that is relevant to AAN interests or activities. Dr. Arrambide has a non-compensated relationship as a Member of the steering group with MOGAD Eugene Devic European Network (MEDEN) that is relevant to AAN interests or activities. Dr. Arrambide has a non-compensated relationship as a Member of the editorial and scientific committee with Acta Neurológica Colombiana that is relevant to AAN interests or activities. Dr. Arrambide has a non-compensated relationship as a Member of the steering committee with CURE-MS that is relevant to AAN interests or activities.
Alvaro Cobo Calvo	Alvaro Cobo Calvo has nothing to disclose.
Romain Marignier, MD, PhD (Lyon University Hospital)	Dr. Marignier has received personal compensation in the range of $0-$499 for serving as a Consultant for UCB. Dr. Marignier has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ALEXION. Dr. Marignier has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ROCHE. Dr. Marignier has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Dr. Marignier has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ROCHE.
Elena Colombo	Elena Colombo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Elena Colombo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Elena Colombo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Elena Colombo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Elena Colombo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Elena Colombo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Elena Colombo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Elena Colombo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Elena Colombo has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen.

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