Outcomes After Acute Plasma Exchange for Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease
3
Issued Date
2025-09-23
Resource Type
eISSN
1526632X
Scopus ID
2-s2.0-105015022999
Pubmed ID
40882166
Journal Title
Neurology
Volume
105
Issue
6
Rights Holder(s)
SCOPUS
Bibliographic Citation
Neurology Vol.105 No.6 (2025) , e213903
Suggested Citation
Thakolwiboon S., Redenbaugh V., Chen B., Hewitt S., Shah S., Lotan I., Levy M., Forcadela M., Huda S., Pique J., Marignier R., Boutiere C., Audoin B., Poullin P., Champsas D., Choi D., Danesh-Meyer H.V., Vasileiou E., Sotirchos E.S., Davis J.B., Henderson A.D., Wilf-Yarkoni A., Stiebel-Kalish H., Maillart E., Bonelli L., Arnold A.C., Boudot De La Motte M., Deschamps R., Jitprapaikulsan J., Moss H.E., Villarreal Navarro S.E., Mao-Draayer Y., Mishra M., Vorasoot N., Cacciaguerra L., Tisavipat N., Tajfirouz D.A., Tillema J.M., Lopez-Chiriboga S.A., Palace J., Hacohen Y., Pittock S.J., Flanagan E.P., Chen J.J. Outcomes After Acute Plasma Exchange for Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease. Neurology Vol.105 No.6 (2025) , e213903. doi:10.1212/WNL.0000000000213903 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/112067
Title
Outcomes After Acute Plasma Exchange for Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease
Author(s)
Thakolwiboon S.
Redenbaugh V.
Chen B.
Hewitt S.
Shah S.
Lotan I.
Levy M.
Forcadela M.
Huda S.
Pique J.
Marignier R.
Boutiere C.
Audoin B.
Poullin P.
Champsas D.
Choi D.
Danesh-Meyer H.V.
Vasileiou E.
Sotirchos E.S.
Davis J.B.
Henderson A.D.
Wilf-Yarkoni A.
Stiebel-Kalish H.
Maillart E.
Bonelli L.
Arnold A.C.
Boudot De La Motte M.
Deschamps R.
Jitprapaikulsan J.
Moss H.E.
Villarreal Navarro S.E.
Mao-Draayer Y.
Mishra M.
Vorasoot N.
Cacciaguerra L.
Tisavipat N.
Tajfirouz D.A.
Tillema J.M.
Lopez-Chiriboga S.A.
Palace J.
Hacohen Y.
Pittock S.J.
Flanagan E.P.
Chen J.J.
Redenbaugh V.
Chen B.
Hewitt S.
Shah S.
Lotan I.
Levy M.
Forcadela M.
Huda S.
Pique J.
Marignier R.
Boutiere C.
Audoin B.
Poullin P.
Champsas D.
Choi D.
Danesh-Meyer H.V.
Vasileiou E.
Sotirchos E.S.
Davis J.B.
Henderson A.D.
Wilf-Yarkoni A.
Stiebel-Kalish H.
Maillart E.
Bonelli L.
Arnold A.C.
Boudot De La Motte M.
Deschamps R.
Jitprapaikulsan J.
Moss H.E.
Villarreal Navarro S.E.
Mao-Draayer Y.
Mishra M.
Vorasoot N.
Cacciaguerra L.
Tisavipat N.
Tajfirouz D.A.
Tillema J.M.
Lopez-Chiriboga S.A.
Palace J.
Hacohen Y.
Pittock S.J.
Flanagan E.P.
Chen J.J.
Author's Affiliation
University of California, Los Angeles
Stanford University
Massachusetts General Hospital
Johns Hopkins University
Mayo Clinic
Tel Aviv University
Northwestern University Feinberg School of Medicine
The University of Auckland
University of Oxford Medical Sciences Division
Vanderbilt University Medical Center
Tongji Medical College of Huazhong University of Science and Technology
Hôpital Universitaire Pitié Salpêtrière
UCL Queen Square Institute of Neurology
Mayo Clinic in Jacksonville, Florida
AP-HM Assistance Publique - Hôpitaux de Marseille
Siriraj Hospital
Wilmer Eye Institute
Faculty of Medicine, Khon Kaen University
Oklahoma Medical Research Foundation
Hopital Neurologique et Neurochirurgical Pierre Wertheimer
Fondation Adolphe de Rothschild
The Walton Centre NHS Foundation Trust
Mayo Clinic Health System
Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle
Stanford University
Massachusetts General Hospital
Johns Hopkins University
Mayo Clinic
Tel Aviv University
Northwestern University Feinberg School of Medicine
The University of Auckland
University of Oxford Medical Sciences Division
Vanderbilt University Medical Center
Tongji Medical College of Huazhong University of Science and Technology
Hôpital Universitaire Pitié Salpêtrière
UCL Queen Square Institute of Neurology
Mayo Clinic in Jacksonville, Florida
AP-HM Assistance Publique - Hôpitaux de Marseille
Siriraj Hospital
Wilmer Eye Institute
Faculty of Medicine, Khon Kaen University
Oklahoma Medical Research Foundation
Hopital Neurologique et Neurochirurgical Pierre Wertheimer
Fondation Adolphe de Rothschild
The Walton Centre NHS Foundation Trust
Mayo Clinic Health System
Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle
Corresponding Author(s)
Other Contributor(s)
Abstract
BACKGROUND AND OBJECTIVES: Data on the plasma exchange (PLEX) in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are limited. Herein, we evaluate outcomes after PLEX in MOGAD. METHODS: This international multicenter retrospective cohort study included patients from 18 tertiary care centers in 6 countries. Inclusion criteria included fulfillment of the 2023 International MOGAD panel criteria, receipt of at least 3 sessions of PLEX, and follow-up of ≥3 months after PLEX. Patients with coexisting neuroinflammatory disorders were excluded. We assessed the frequency of complete recovery (CR), clinically significant improvement (CSI), visual acuity (VA), and Expanded Disability Status Scale (EDSS). Logistic regression analyses were performed to identify predictors of CR and CSI. RESULTS: Of 234 patients, 135 (58%) were female. The median (interquartile range [IQR]) age at attack was 34 (IQR 22-49) years, and 42 (17%) were children. In 165 of 243 (68%), the attack treated with PLEX was the first attack. Attack phenotypes included 161 optic neuritis (235 eyes), 77 myelitis, 24 acute disseminated encephalomyelitis, 15 brainstem/cerebellar, 3 cerebral-cortical encephalitis attack, and 1 cerebral polyfocal deficit-36 with >1 core phenotypes. A total of 239 (99%) attacks were also treated with corticosteroids and 32 (13%) with IV immunoglobulins. VA in optic neuritis improved from 20/400 (20/70-hand motion) to 20/20 (20/20-20/30), p < 0.001, and EDSS decreased from a median of 4.0 (3.0-6.5) to 1.0 (0.0-2.5), p < 0.001. Of 229 attacks without subsequent attacks within 3 months, 100 (44%) achieved CR and 213 (93%) CSI. The probability of CR was decreased with advanced age (adjusted odd ratio [95% CI] 0.97 [0.96-0.99] per year), higher EDSS worsening from baseline (0.66 [0.54-0.81] per 0.5 increment) and delayed PLEX (0.98 [0.96-0.99] per day). Advanced age (0.97 [0.96-0.99] per year) and delayed PLEX (0.95 [0.94-0.96] per day) decreased the probability of CSI. DISCUSSION: We observed favorable outcomes after PLEX in MOGAD attacks. However, advanced age and delayed initiation of PLEX were associated with a reduced probability of improvement. The absence of a control group limits our ability to differentiate PLEX effects from spontaneous recovery, prior corticosteroid response, or long-term immunotherapy. Future prospective studies are needed to assess the impact of PLEX on improvement. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that PLEX is associated with favorable clinical outcomes in patients with MOGAD.