Abstract Details

Title MOGAD Clinical Characteristics, Treatments, and Outcomes in Singapore: A Nationwide Observational Cohort Study

Topic Autoimmune Neurology

Presentation(s) P6 - Poster Session 6 (5:00 PM-6:00 PM)

Poster/Presentation
Number 1-009

Objective We investigated clinical features, long-term sequelae of MOGAD (myelin oligodendrocyte glycoprotein antibody-associated disease) patients in Singapore and examined factors associated with relapses and unfavorable neurological outcomes.

Background MOGAD is a inflammatory demyelinating disease of the central nervous system. In Singapore, a multi-ethnic Southeast Asian population, its clinical phenotypes and optimal treatment strategies are still poorly defined.

Design/Methods This retrospective cohort study involved all public healthcare institutions in Singapore, including patients with a first attack before January 2024. All patients had at least one inflammatory attack consistent with MOGAD, with positive MOG antibodies on cell-based assays. Clinical, investigational, treatment, outcome data (visual acuity [VA] and Expanded Disability Status Scale [EDSS]) were collected. Relapse-free survival was estimated using Kaplan-Meier method. Predictors of relapse and poor functional outcomes were assessed using Cox proportional hazards model and logistic regression.

Results 130 patients were included (107 adult, 23 pediatric cases). The median follow-up duration was 21.3 months (IQR 8.4–52.4 months). Median age of onset was 34 years (range 3–80). Optic neuritis (ON) was the most common onset phenotype (61.5%), followed by transverse myelitis (11.5%) and cerebral cortical encephalitis (CCE) (8.5%). Pediatric patients presented more commonly with acute disseminated encephalomyelitis or CCE than adults (52.2% vs 10.2%, p<0.0001). 45 patients (34.6%) relapsed, with median time of 5.9 months (range 0.7–160.3) to first relapse. At last follow-up, severe (VA≤0.1) and moderate (≤0.7) visual loss occurred in 1 (1.1%) and 23 (25.3%) patients with ON respectively, while EDSS ≥6 occurred in 6.4% of non-ON phenotypes. Patients receiving ≥3 months of maintenance immunosuppression after first attack had a significantly lower relapse risk than those given shorter or no treatment (log-rank test, p=0.029).

Conclusions Our findings highlight that (1) neurological prognosis is generally favorable in MOGAD, (2) relapse risk is greatest shortly after sentinel attack, (3) maintenance treatment ≥3 months significantly reduced relapse risk.

Authors/Disclosures
Xin Yang, MBBS PRESENTER	Dr. Yang has nothing to disclose.
Shakran Mahmood	Mr. Mahmood has nothing to disclose.
Seyed Ehsan Saffari (National University of Singapore)	Seyed Ehsan Saffari has nothing to disclose.
Jeanne M. Tan, MD, PhD (NNI)	Dr. Tan has nothing to disclose.
Kevin Tan, MD, FAAN (National Neuroscience Institute)	Dr. Tan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Tan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Tan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck.
Amy M. Quek, MBBS (National University Hospital)	The institution of Dr. Quek has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. The institution of Dr. Quek has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. The institution of Dr. Quek has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Astra Zeneca. The institution of Dr. Quek has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. The institution of Dr. Quek has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. The institution of Dr. Quek has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Astra Zeneca.
Yihui Goh, MBBS (National University Hospital)	Dr. Goh has nothing to disclose.
Derek T. Soon, MBBS, PhD (NUHS)	Dr. Soon has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Legal Clinic.
Steven M. Thomas, MPH	Mr. Thomas has nothing to disclose.
Simon Ling, MBBS, FRACP	Dr. Ling has nothing to disclose.
Kok Pin Yong, MB BCh BAO	Dr. Yong has nothing to disclose.
Sarah Hasnor Abu Hassan, MBChB (National Neuroscience Institute (SGH Campus))	Dr. Abu Hassan has nothing to disclose.
Shweta Singhal, MD, PhD	Dr. Singhal has nothing to disclose.
Reuben Foo, MBBS	Dr. Foo has nothing to disclose.
Oliver Mah, MBBS	Dr. Mah has nothing to disclose.
Su Ann a. LIm, MBBS	Dr. LIm has nothing to disclose.
Chee Fang Chin, MD	Dr. Chin has nothing to disclose.
Kelvin Z. Li, MBBS, MMed, MTech	Dr. Li has nothing to disclose.
Nathan T. Han	Mr. Han has nothing to disclose.
Cuiwei Wang, MS	Mrs. Wang has received personal compensation for serving as an employee of Abbvie. Mrs. Wang has stock in Abbvie.
HIAN TAT ONG, MD	Dr. ONG has nothing to disclose.
Tianrong Yeo, MBBS (National Neuroscience Institute)	The institution of Dr. Yeo has received personal compensation in the range of $0-$499 for serving as a Consultant for Edanz Pharma. The institution of Dr. Yeo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. The institution of Dr. Yeo has received personal compensation in the range of $0-$499 for serving as a Consultant for Novartis . The institution of Dr. Yeo has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Terumo BCT. The institution of Dr. Yeo has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Euroimmun AG . The institution of Dr. Yeo has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Merck. The institution of Dr. Yeo has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Novartis . The institution of Dr. Yeo has received research support from National Medical Research Council (Singapore) . The institution of Dr. Yeo has received research support from Roche .

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