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Long-term efficacy of mycophenolate mofetil in myelin oligodendrocyte glycoprotein antibody-associated disorders: A prospective study

OBJECTIVE: To investigate whether the use of mycophenolate mofetil (MMF) could reduce the relapse risk in patients with myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G (IgG)-associated disorders (MOGADs). METHODS: This prospective observational cohort study included patients with MOGAD at...

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Autores principales: Li, Shengde, Ren, Haitao, Xu, Yan, Xu, Tao, Zhang, Yao, Yin, Hexiang, Zhang, Weihua, Li, Jiuwei, Ren, Xiaotun, Fang, Fang, Li, Wenhan, Zhu, Yicheng, Peng, Bin, Wang, Jing, Zhong, Yong, Cui, Liying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136046/
https://www.ncbi.nlm.nih.gov/pubmed/32170045
http://dx.doi.org/10.1212/NXI.0000000000000705
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author Li, Shengde
Ren, Haitao
Xu, Yan
Xu, Tao
Zhang, Yao
Yin, Hexiang
Zhang, Weihua
Li, Jiuwei
Ren, Xiaotun
Fang, Fang
Li, Wenhan
Zhu, Yicheng
Peng, Bin
Wang, Jing
Zhong, Yong
Cui, Liying
author_facet Li, Shengde
Ren, Haitao
Xu, Yan
Xu, Tao
Zhang, Yao
Yin, Hexiang
Zhang, Weihua
Li, Jiuwei
Ren, Xiaotun
Fang, Fang
Li, Wenhan
Zhu, Yicheng
Peng, Bin
Wang, Jing
Zhong, Yong
Cui, Liying
author_sort Li, Shengde
collection PubMed
description OBJECTIVE: To investigate whether the use of mycophenolate mofetil (MMF) could reduce the relapse risk in patients with myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G (IgG)-associated disorders (MOGADs). METHODS: This prospective observational cohort study included patients with MOGAD at Peking Union Medical College Hospital between January 1, 2017, and April 30, 2019. The patients were divided into 2 groups: those with (MMF+) or without (MMF−) MMF therapy. The primary outcome was relapse at follow-up. We used Cox proportional hazards models to calculate hazard ratios (HRs) for relapse. RESULTS: Seventy-nine patients were included in our MOG cohort. Fifty (63.3%) were adults at index date, and 47 (59.5%) were women. Fifty-four (68.4%) were in the MMF+ group, and 25 (31.6%) were in the MMF− group. Clinical and demographic factors, MOG-IgG titer, and follow-up time (median, 472.5 days for MMF+, 261.0 days for MMF−) were comparable between the groups. Relapse rates were 7.4% (4/54) in the MMF+ group and 44.0% (11/25) in the MMF− group. Of all potential confounders, only the use of MMF was associated with reduced risk of relapse. The HR for relapse among patients in the MMF+ group was 0.14 (95% CI, 0.05–0.45) and was 0.08 (95% CI, 0.02–0.28) in a model adjusted for age, sex, disease course, and MOG-IgG titer. MMF therapy also remained associated with a reduced relapse risk in sensitivity analyses. Only one patient (1.9%) discontinued MMF therapy because of adverse effect. CONCLUSIONS: These findings provide a clinical evidence that MMF immunosuppression therapy may prevent relapse in patients with MOGAD. CLASSIFICATION OF EVIDENCE: This study provides class IV evidence that for patients with MOGAD, MMF reduces relapse risk.
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spelling pubmed-71360462020-04-17 Long-term efficacy of mycophenolate mofetil in myelin oligodendrocyte glycoprotein antibody-associated disorders: A prospective study Li, Shengde Ren, Haitao Xu, Yan Xu, Tao Zhang, Yao Yin, Hexiang Zhang, Weihua Li, Jiuwei Ren, Xiaotun Fang, Fang Li, Wenhan Zhu, Yicheng Peng, Bin Wang, Jing Zhong, Yong Cui, Liying Neurol Neuroimmunol Neuroinflamm Article OBJECTIVE: To investigate whether the use of mycophenolate mofetil (MMF) could reduce the relapse risk in patients with myelin oligodendrocyte glycoprotein (MOG)-immunoglobulin G (IgG)-associated disorders (MOGADs). METHODS: This prospective observational cohort study included patients with MOGAD at Peking Union Medical College Hospital between January 1, 2017, and April 30, 2019. The patients were divided into 2 groups: those with (MMF+) or without (MMF−) MMF therapy. The primary outcome was relapse at follow-up. We used Cox proportional hazards models to calculate hazard ratios (HRs) for relapse. RESULTS: Seventy-nine patients were included in our MOG cohort. Fifty (63.3%) were adults at index date, and 47 (59.5%) were women. Fifty-four (68.4%) were in the MMF+ group, and 25 (31.6%) were in the MMF− group. Clinical and demographic factors, MOG-IgG titer, and follow-up time (median, 472.5 days for MMF+, 261.0 days for MMF−) were comparable between the groups. Relapse rates were 7.4% (4/54) in the MMF+ group and 44.0% (11/25) in the MMF− group. Of all potential confounders, only the use of MMF was associated with reduced risk of relapse. The HR for relapse among patients in the MMF+ group was 0.14 (95% CI, 0.05–0.45) and was 0.08 (95% CI, 0.02–0.28) in a model adjusted for age, sex, disease course, and MOG-IgG titer. MMF therapy also remained associated with a reduced relapse risk in sensitivity analyses. Only one patient (1.9%) discontinued MMF therapy because of adverse effect. CONCLUSIONS: These findings provide a clinical evidence that MMF immunosuppression therapy may prevent relapse in patients with MOGAD. CLASSIFICATION OF EVIDENCE: This study provides class IV evidence that for patients with MOGAD, MMF reduces relapse risk. Lippincott Williams & Wilkins 2020-03-13 /pmc/articles/PMC7136046/ /pubmed/32170045 http://dx.doi.org/10.1212/NXI.0000000000000705 Text en Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Article
Li, Shengde
Ren, Haitao
Xu, Yan
Xu, Tao
Zhang, Yao
Yin, Hexiang
Zhang, Weihua
Li, Jiuwei
Ren, Xiaotun
Fang, Fang
Li, Wenhan
Zhu, Yicheng
Peng, Bin
Wang, Jing
Zhong, Yong
Cui, Liying
Long-term efficacy of mycophenolate mofetil in myelin oligodendrocyte glycoprotein antibody-associated disorders: A prospective study
title Long-term efficacy of mycophenolate mofetil in myelin oligodendrocyte glycoprotein antibody-associated disorders: A prospective study
title_full Long-term efficacy of mycophenolate mofetil in myelin oligodendrocyte glycoprotein antibody-associated disorders: A prospective study
title_fullStr Long-term efficacy of mycophenolate mofetil in myelin oligodendrocyte glycoprotein antibody-associated disorders: A prospective study
title_full_unstemmed Long-term efficacy of mycophenolate mofetil in myelin oligodendrocyte glycoprotein antibody-associated disorders: A prospective study
title_short Long-term efficacy of mycophenolate mofetil in myelin oligodendrocyte glycoprotein antibody-associated disorders: A prospective study
title_sort long-term efficacy of mycophenolate mofetil in myelin oligodendrocyte glycoprotein antibody-associated disorders: a prospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136046/
https://www.ncbi.nlm.nih.gov/pubmed/32170045
http://dx.doi.org/10.1212/NXI.0000000000000705
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