Usefulness of IgG oligoclonal bands, antibodies to MOG (MOG-IgG), and the application of the 2017 McDonald criteria in the evaluation of children with a first demyelinating episode: a prospective multicenter study
ECTRIMS Online Library. Armangue T. 10/10/18; 231806; 64
Thais Armangue
Thais Armangue

Abstract: 64

Type: Scientific Session

Abstract Category: Clinical aspects of MS - Paediatric MS

Introduction: Information on the application of the revised 2017 McDonald criteria in children is limited. The role of biomarkers to confirm or discard MS diagnosis is uncertain.
Objectives: 1) To compare the application of the 2017 and 2010 McDonald criteria in children with a first demyelinating event, and 2) To evaluate the contribution of biomarkers: oligoclonal bands (OB), acquaporin 4 (AQP4) and MOG-IgG in predicting their clinical course.
Methods: Prospective cohort of children (< 18 years) followed from a first demyelinating episode. Serum/CSF samples (< 3 months from disease onset) were investigated for OB, AQP4 and MOG-IgG. Thirty-seven MRI items were systematically analysed blinded to clinical and immunological data. We evaluated the proportion of patients fulfilling the 2010 and the 2017 McDonald criteria at baseline and the contribution of biomarkers in predicting the clinical course
Results: Clinical and baseline MRI data were available for 55 children (45% female) with a median (IQR) age of 6.2 (3.5-13.6) years (67% < 12years). At baseline, the diagnosis according to 2010 McDonald and 2013 IPMSSG criteria were ADEM (n=28), MS (n=3), classical CIS (n=17), RIS (n=1), and other in 6 (MRI suggestive of ADEM but without encephalopathy). After a median (IQR) follow-up of 16 (7-26) months the diagnosis changed in 10 patients because of clinical (n=5) or radiological (n=5) activity: 7 patients evolved to MS (6 patients with classical CIS and 1 with RIS), 1 to relapsing ON, 1 to ADEM-ON (ADEM followed by ON), and 1 to neuromyelitis optica spectrum disorder (NMOSD). None of the 7 patients with available baseline samples who evolved to MS had MOG-IgG in comparison to 22/38(58%) who did not evolve (p=0.01). None had AQP4. In contrast, 5/7 (71%) patients with MS had positive OB compared to 1/26 (4%) who did not develop MS (p< 0.001). At baseline, 3/10 already fulfilled the 2010 McDonald criteria; 4 additional patients (7/10) fulfilled the 2017 MS criteria thanks to the contribution of OB.
Conclusions: The application of the 2017 McDonald criteria in children is feasible and allows an earlier diagnosis of MS. Presence of OB and negativity of MOG-IgG are useful biomarkers when evaluating the risk of MS in children with a first demyelinating event.
Disclosure: TA, GA and CA share first authorship
AS and MT share last authorship
This work was supported in part by Fundació Marató TV3 (20141830, TA, MS, FG, AS, MT, GA).
TA, FG, MMB, MP, AF, PM report no disclosures
AM: has received speaking honoraria from Novartis;
AR serves on scientific advisory boards for Biogen Idec, Bayer, Novartis, Genzyme, and OLEA Medical, and on the editorial board of the American Journal of Neuroradiology, Neuroradiology and European Radiology, has received speaker honoraria from Bayer, Genzyme, Sanofi-Aventis, Bracco, Merck-Serono, Teva Pharmaceutical Industries Ltd, OLEA Medical, Stendhal, Novartis and Biogen Idec, and has research agreements with Siemens AG;
AS has received compensation for consulting services and speaker honoraria from Bayer-Schering, Merck-Serono, Biogen-Idec, Sanofi-Aventis, Teva Pharmaceutical Industries Ltd and Novartis;
CA has received speaking honoraria from Novartis, Biogen and Stendhal;
GA has received compensation for consulting services from Biogen-Idec, research support from Novartis, travel expenses for scientific meetings from Novartis, Roche, and Stendhal, and speaking honoraria from Sanofi-Aventis and Stendhal.
MS received speaker honoraria from Genzyme and Novartis, and funding from the Generalitat de Catalunya (SLT002/16/00354);
MT has received compensation for consulting services and speaking honoraria from Bayer Schering Pharma, Merck-Serono, Biogen-Idec, Teva Pharmaceuticals, Sanofi-Aventis, Novartis, Almirall, Genzyme, and Roche.
NSV receives funding from the Spanish Government (Instituto de Salud Carlos III, Spain, and Fondo Europeo de Desarrollo Regional [FEDER, FI16/00251], and the Predoctoral Grant for Health Research)
XM has received speaking honoraria and travel expenses for participation in scientific meetings, has been a steering committee member of clinical trials or participated in advisory boards of clinical trials in the past with Actelion, Amirall, Bayer, Biogen, Celgene, Genzyme, Hoffmann-La Roche, Novartis, Oryzon Genomics, Sanofi-Genzyme and Teva Pharmaceutical.
YB has received speaking honoraria from Biogen, Novartis and Genzyme

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