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Abstract Details

Clinical Characteristics of Multiple Sclerosis Patients with Seropositive MOG Antibody Test
Autoimmune Neurology
P1 - Poster Session 1 (12:00 PM-1:00 PM)
1-029
To determine if multiple sclerosis (MS) patients who test positive for the myelin oligodendrocyte glycoprotein (MOG) antibody test have different disease characteristics than typically seen in MS.
MS and MOG associated-antibody disease (MOGAD) are distinct CNS demyelinating disorders with different courses and treatments but can be difficult to distinguish from each other. Some patients who meet McDonald criteria for MS also have MOG antibodies, the significance of which is unknown.

Patients at Mass General Brigham with MOG IgG1 antibodies in serum by cell-based assay (n=295) who did not meet criteria for a diagnosis of MOGAD (n=59) underwent chart review to extract patients who met current McDonald diagnostic criteria for MS as determined by a consensus of 3 MS neurologists. Ten such patients were identified.
Of these 10 patients, 70% (n=7) were female and had a mean age at onset of 27.4 years (SD=10.5). All had MOG IgG1 titers of  ≤1:20 except one with a titer of 1:100. Of the 5 patients with repeat antibody testing, only one sero-reverted. Phenotypically, one had perineural optic nerve enhancement while another had a longitudinally extensive optic nerve lesion on MRI. Six of ten patients developed new MRI lesions while on high efficacy MS therapies for ≥6 months.
We studied the course of 10 patients who met criteria for MS who had positive MOG antibodies. Overall, clinical, radiological, and serum and CSF biomarker findings conformed to expectations for MS patients. However, some radiological features of optic neuritis more consistent with MOGAD were seen, and interestingly, 60% had MRI lesion accrual on high-efficacy MS therapy, much greater than would be expected. Our findings raise the hypothesis that the presence of MOG antibodies in MS impacts disease course. A larger prospective study is needed to confirm our findings. 
Authors/Disclosures
Amara Plaza-Jennings, MD, PhD
PRESENTER 		Dr. Plaza-Jennings has nothing to disclose.
Philippe-Antoine Bilodeau, MD (Massachusetts General Hospital) The institution of Dr. Bilodeau has received research support from Alexion Pharmaceuticals. The institution of Dr. Bilodeau has received research support from Department of Defense. Dr. Bilodeau has received research support from Canadian Institutes of Health Research. The institution of Dr. Bilodeau has received research support from Ann Theodore Foundation. Dr. Bilodeau has received research support from The MOG Project.
Anastasia Vishnevetsky, MD (Massachusetts General Hospital) The institution of Dr. Vishnevetsky has received research support from National MS Society. The institution of Dr. Vishnevetsky has received research support from NIH (NeuroNext).
Michael Levy, MD, PhD, FAAN (Massachusetts General Hospital/Harvard Medical School) Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Pharma. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB Pharma. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Levy 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. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Levy has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Levy has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Levy has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various law firms. The institution of Dr. Levy has received research support from National Institutes Health.
Jodie Burton, MD, FAAN Dr. Burton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Dr. Burton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Burton has received personal compensation in the range of $0-$499 for serving as a Consultant for Horizon. The institution of Dr. Burton has received research support from Roy and Joan Allen Professorship for Sight. Dr. Burton has a non-compensated relationship as a Advisor with CADTH that is relevant to AAN interests or activities. Dr. Burton has a non-compensated relationship as a Advisor with Alexion that is relevant to AAN interests or activities. Dr. Burton has a non-compensated relationship as a Advisor with Horizon that is relevant to AAN interests or activities. Dr. Burton has a non-compensated relationship as a 好色先生al Chair with EMD Serono that is relevant to AAN interests or activities.