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Evaluation of treatment response in adults with relapsing MOG-Ab- associated disease
ECTRIMS Online Library. Cobo- Calvo A. Oct 12, 2018; 232048
Alvaro Cobo- Calvo
Alvaro Cobo- Calvo
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Abstract: 295

Type: Scientific Session

Abstract Category: Clinical aspects of MS - MS Variants

Introduction: Myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) are related to several acquired demyelinating syndromes in adults, but the therapeutic approach is currently unclear.
Aims: We aimed to describe the response to different therapeutic strategies in adult patients with relapsing MOG-Ab-associated disease.
Methods: Retrospective study conducted in France and Spain including 125 relapsing MOG-Ab patients aged ≥18 years. First, we performed survival analysis to investigate time to relapse between treated and non-treated patients, performing a propensity score method based on inverse probability of treatment weighting. Secondly, we assessed the annualized relapse rates (ARR) and Expanded Disability Status Scale (EDSS) pre-treatment and on/end-treatment.
Results: Median age at onset was 34.1 years (range: 18.0-­67.1), the female:male ratio 1.2:1, and 96% were Caucasian. At 5-years 84% (95% confidence interval [CI], 77.1-89.8) patients relapsed At last follow-up, 66 (52.8%) received maintenance therapy. Patients initiating immunosuppressants (azathioprine, mycophenolate mofetil [MMF], rituximab) were at lower risk of relapse in comparison to non-treated patients (HR, 0.47; 95CI%, 0.23-0.96; p=0.040). Mean ARR (standard deviation) was reduced from 1.05(1.20) to 0.43(0.79) with azathioprine (n=11; p=0.041), from 1.20(1.11) to 0.23(0.60) with MMF (n=11; p=0.033), and from 1.08(0.98) to 0.43(0.89) with rituximab (n=26; p=0.012). Other immunosuppressants
(methotrexate/mitoxantrone/cyclophosphamide; n=5), or multiple sclerosis-disease modifying drugs (MS­DMD; n=9) were not associated with significant reduced ARR. Higher rates of freedom of EDSS-progression were observed with azathioprine, MMF or rituximab.
Conclusion: In adults with relapsing MOG­Ab­associated disease, immunosuppressant therapy (azathioprine, MMF and rituximab) but no MS­DMD is associated with reduced risk of relapse, and better disability outcomes
Disclosure: Cobo-Calvo has received grant from Fundación Alfonso Martin Escudero. Sepulveda, Fabien Rollot, Armangué, Ruiz, Maillart, Papeix, Audoin and Zephir report no disclosures. Biotti has received consulting and lecturing fees and travel grants from Biogen Idec, Genzyme, Novartis, Merck Serono, Roche, Sanofi Aventis and Teva Pharma. Ciron serves on scientific advisory board for Merck Serono and Roche, and has received funding for travel and honoraria from Biogen, Novartis, Genzyme, Teva Pharmaceuticals, Merck Serono and Roche, with no relation with the submitted work. Durand-Dubief serves on scientific advisory board for Merck Serono and has received funding for travel and honoraria from Biogen Idec, Merck Serono, Novartis, Sanofi-Genzyme, Roche and Teva. Collongues reports no disclosures. Ayrignac, Thouvenot report no disclosures. Bourre has received consulting and lecturing fees, travel grants and research support from Biogen, Genzyme, Novartis, Merck Serono, Roche, Sanofi and Teva Pharma. Montcuquet has received funding for travel from Merck Serono, Teva, Novartis, Sanofi-Genzyme and Biogen. Cohen received honoraria for participation to advisory boards from Biogen, Novartis, Roche and Ad Scientam, with no relation to this study. Deschamps reports no disclosures. Solà-Valls receives funding from the Instituto de Salud Carlos III, Spain and Fondo Europeo de Desarrollo Regional (FEDER) (FI16/00251), Predoctoral Grant for Health Research (PFIS). Llufriu reports no disclosures. De Seze reports no disclosures. Blanco reports no disclosures; Vukusic has received consulting and lecturing fees, travel grants and research support from Biogen, Geneuro, Genzyme, Novartis, Merck Serono, Roche, Sanofi Aventis and Teva Pharm. Saiz has received travel funding and/or speaker honoraria from Bayer-Schering, Merck-Serono, Biogen Idec, Sanofi-Aventis,Teva Pharmaceutical Industries, Novartis and Roche. Marignier has received consulting and lecturing fees, travel grants and research support from Bayer-Schering, Biogen Idec, Genzyme, Novartis, Merck Serono, Roche, Sanofi Aventis and Teva Pharma.

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