Abstract Details

Title Anti-MOG IgG1 Antibodies in Children

Topic Child Neurology and Developmental Neurology

Presentation(s) S19 - Child Neurology: Updates in Autism, Migraine, MS, and Stroke (4:14 PM-4:25 PM)

Poster/Presentation
Number 005

Background

Up to 70% of children with ADS have MOGabs. The full range of MOG-associated clinical features, at onset and over time need clarification.

Objective

To compare clinical features and outcomes of children with acquired demyelinating syndromes (ADS) with and without antibodies to Myelin Oligodendrocyte Glycoprotein (MOGabs).

Design/Methods

We assessed MOGabs using cell-based assays, blinded to clinical status, at the time of incident ADS in 275 children. The serological status, MRI features and clinical course of these children were prospectively assessed over a median of 6 years, and compared between MOG+ and MOG- children using descriptive statistics.

Results MOGabs were detected in 84/275 (31%) children at onset. Seropositive children were younger than seronegative ones (7.3 v 12.4 years; p<0.0001). The clinical presentations included a combination of optic neuritis, transverse myelitis or acute disseminated encephalomyelitis for 95% of MOG+ children. Brain lesions were present in 51/84 MOG+ children. Twenty-six of these (51%) exhibited complete lesion resolution over time compared to 20% of MOG- children (p = 0.00016). The remaining MOG+ patients had diminished total T2 lesion volume at last MRI scan (p = 0.0013). Serial analysis revealed a high rate of seronegative conversion, with 40/84 (48%) initially seropositive converting to seronegative status after a median (IQR) of 1 (0.36-2.07) year (2 treated with DMTs). Clinical relapses occurred in only 16/84 (19%) MOG+children, 9 of whom (56%) were persistently positive over extended follow-up (median 6.5y), and in 38 MOG- patients (21%), 37 of whom diagnosed with MS. EDSS at last visit was lower in the 84 MOG+ ADS patients compared to the 54 MOG- ones diagnosed with MS (p = 0.0004).

Conclusions

About 50% of MOG+ children convert to MOG- status a median of 1 year after onset. A major proportion of MOG+ patients have a monophasic course characterized by MRI lesion resolution and low residual disability.

Authors/Disclosures
Giulia Fadda, MD (University of Ottawa) PRESENTER	Dr. Fadda has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen/Horizon Therapeutics. Dr. Fadda has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Novartis.
Patrick Waters, PhD (Oxford Autoimmune Neurology Diagnostic Lab - Nuffield Clinical Neurosciences)	Dr. Waters has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Waters has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. Dr. Waters has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UBC. Dr. Waters has received intellectual property interests from a discovery or technology relating to health care.
Nadia M. Celestin, BS (Tisch MS Research Center of New York)	Miss Celestin has nothing to disclose.
Sarosh R. Irani, MD, PhD, FRCP, FEAN (Mayo Clinic)	Dr. Irani has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for UCB, Immunovant, MedImmun, Roche, Janssen, Cerebral therapeutics, Biogen, Amgen, Argenex, Clarivate, IQVIA, BioHaven therapeutics, ADC therapeutics, Brain, CSL Behring, and ONO Pharma.. Dr. Irani has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Irani has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Irani has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Brain. Dr. Irani has received personal compensation in the range of $100,000-$499,999 for serving as an Expert Witness for LLPs. Dr. Irani has received intellectual property interests from a discovery or technology relating to health care. Dr. Irani has received intellectual property interests from a discovery or technology relating to health care. Dr. Irani has received intellectual property interests from a discovery or technology relating to health care.
Julia O'Mahony (The Hospital for Sick Children)	Ms. O'Mahony has nothing to disclose.
Robert A. Brown, PhD (ShadowLab Reseaerch)	Dr. Brown has received stock or an ownership interest from ShadowLab Research Inc.. Dr. Brown has received intellectual property interests from a discovery or technology relating to health care. Dr. Brown has a non-compensated relationship as a consultant with the Population Council that is relevant to AAN interests or activities.
	No disclosure on file
Giulia Longoni, MD (The Hospital for Sick Children)	Dr. Longoni has nothing to disclose.
E. Ann Yeh, MD, MA, FRCPC (Hosptial for Sick Children)	Dr. Yeh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Yeh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for PRIME. Dr. Yeh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Yeh has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. The institution of Dr. Yeh has received research support from Biogen. The institution of Dr. Yeh has received research support from Stem Cell Network. The institution of Dr. Yeh has received research support from CIHR. The institution of Dr. Yeh has received research support from Ontario Institute for Regenerative Medicine. The institution of Dr. Yeh has received research support from National MS Society. The institution of Dr. Yeh has received research support from NIH. The institution of Dr. Yeh has received research support from SickKids Foundation. The institution of Dr. Yeh has received research support from CMSC. The institution of Dr. Yeh has received research support from MSSC.
Ruth-Ann Marrie, MD, PhD (University of Manitoba)	The institution of Dr. Marrie has received research support from CIHR. The institution of Dr. Marrie has received research support from MS Canada. The institution of Dr. Marrie has received research support from National MS Society. The institution of Dr. Marrie has received research support from Crohn's and Colitis Canada. The institution of Dr. Marrie has received research support from US Department of Defense. The institution of Dr. Marrie has received research support from The Arthritis Society. The institution of Dr. Marrie has received research support from CMSC.
Douglas L. Arnold, MD, FAAN (Montreal Neurological Institute, McGill Univ)	Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for BMS. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Frequency Therapeutics. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Xfacto communications. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Find therapeutics. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GSK. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Idorsia. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kiniksa. Dr. Arnold has stock in NeuroRx.
Brenda L. Banwell, MD, FAAN (Childrens Hospital of Philadelphia)	Dr. Banwell has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Banwell has received personal compensation in the range of $0-$499 for serving as a Consultant for UCB. Dr. Banwell has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Banwell has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Banwell has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Banwell has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. The institution of Dr. Banwell has received research support from National MS Society. The institution of Dr. Banwell has received research support from NIH.
Amit Bar-Or, MD, FRCPC (University of Pennsylvania)	Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche Genentech. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merk/EMD Serono. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi-Genzyme. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving as a Consultant for cabaletta. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche/Genentech. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck/EMD Serono. Dr. Bar-Or has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi/Genzyme. The institution of Dr. Bar-Or has received research support from Novartis. The institution of Dr. Bar-Or has received research support from Biogen. The institution of Dr. Bar-Or has received research support from Roche/Genentech.