| Title: |
Disability and Relapse Risk in Late-Onset Myelin Oligodendrocyte Glycoprotein Antibody–Associated Disease |
| Authors: |
Ju, H; Kim, KH; Woo, SY; Chung, YH; Kim, HJ; Kim, H; Lee, EJ; Lim, YM; Ju, W; Kim, SM; Kwon, YN; Kim, SW; Shin, HY; Joo, IS; Kim, S; Seok, HY; Bong, JB; Yoon, BA; Kim, JK; Kang, YR; Nam, TS; Sohn, E; Kim, W; Seok, JM; Lee, HS; Oh, SY; Ahn, SW; Lee, S; Lee, TK; Lee, HL; Kim, NH; Oh, J; Kim, JE; Kwon, S; Oh, SI; Park, MS; Bae, JS; Park, JW; Kim, BJ; Yang, J; Kim, SH; Min, JH |
| Contributors: |
100365; Joo, IS |
| Publication Year: |
2026 |
| Subject Terms: |
Adolescent; Adult; Age of Onset; Disability Evaluation; Female; Humans; Male; Middle Aged; Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease; Myelin-Oligodendrocyte Glycoprotein; Persons with Disabilities; Recurrence; Republic of Korea; Retrospective Studies; Young Adult |
| Description: |
IMPORTANCE: The impact of late onset in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is still controversial. OBJECTIVE: To investigate the association of late onset MOGAD with moderate disability and relapse in Korean patients. DESIGN, SETTING, AND PARTICIPANTS: This nationwide, multicenter, retrospective cohort study included adult patients with a diagnosis of MOGAD according to the 2023 international diagnostic criteria between August 2018 and September 2024 across 28 hospitals in South Korea. EXPOSURE: Age at onset of MOGAD, categorized into adult-onset MOGAD (AO-MOGAD; 18-49 years) and late-onset MOGAD (LO-MOGAD; >/=50 years). MAIN OUTCOMES AND MEASURES: The primary outcomes were time to first relapse in patients with a disease duration of 12 or more months and moderate disability, defined as Expanded Disability Status Scale (EDSS) score of 3 or greater at last follow-up. RESULTS: A total of 350 patients (mean [SD] age at onset, 43.2 [15.0] years; 189 female [54.0%]) with a median (IQR) baseline EDSS of 3.0 (2.0-4.0) were included, with 124 patients (35.4%) with LO-MOGAD and 226 patients (64.6%) with AO-MOGAD. The LO-MOGAD group had less frequent brain involvement than the AO-MOGAD group at onset (26 patients [21.0%] vs 75 patients [33.2%]; P = .02) and during the disease course (28 patients [22.6%] vs 95 patients [42.0%]; P < .001), while optic neuritis or myelitis was comparable between the 2 groups. The LO-MOGAD group showed more frequent monophasic course (55 of 95 patients [57.9%] vs 75 of 188 patients [39.9%]; P = .004), but higher EDSS score at last follow-up (median [IQR], 2.0 [1.0-2.0] vs 1.0 [0.0-2.0]; P < .001) compared with those in the AO-MOGAD group. However, late onset was not significantly associated with the time to first relapse in multivariable analysis (adjusted hazard ratio, 0.72; 95% CI, 0.48-1.08; P = .11), which was consistent after propensity score matching. By contrast, late onset was associated with a significantly higher risk of moderate ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
J010139087; http://repository.ajou.ac.kr/handle/201003/34996; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12905660 |
| DOI: |
10.1001/jamanetworkopen.2025.59471 |
| Availability: |
http://repository.ajou.ac.kr/handle/201003/34996; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12905660; https://doi.org/10.1001/jamanetworkopen.2025.59471 |
| Accession Number: |
edsbas.4A7EF5E0 |
| Database: |
BASE |