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How do you approach the management of patients with one clinical demyelinating event and MOG+ antibody status?

Do you wait for a second clinical event or start immunomodulatory therapy right away?
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Have you ever used tocilizumab for MOGAD relapse prevention?

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3 Answers
Mednet Member
Mednet MemberInvited Expert
Neurology · UVA Health
Answered on

I do not always treat a MOG+ single event (isolated optic neuritis, isolated transverse myelitis, or ADEM-like presentation) as it is possible that it might be a one-time-only event (as might occur after a viral illness or vaccination).

If there has been "dissemination in time", then I would conside...

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Mednet Member
Mednet Member
Neurology · US Air Force
Answered on

As Dr. @Dr. First Last and Dr. @Dr. First Last described, this is a great but tough question. As we know, all patients with MOGAD do not have a relapsing disease course, but I think it is also important to consider that the relapsing course of MOGAD can be very different than other demyelinating dis...

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Mednet Member
Mednet MemberInvited Expert
Neurology · University of Kentucky
Answered on

I typically treat this group of patients. The antibody titer levels are perhaps important to correlate with disease phenotype but because antibodies fluctuate, it is almost impossible to predict if the patient will have another demyelinating event and have a catastrophic event. Since MOGAD has no FD...

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