Meta-analysis of the effectiveness of relapse prevention therapy for myelin-oligodendrocyte glycoprotein antibody-associated disease

被引:13
作者
Chang, Xuting [1 ]
Zhang, Jie [1 ]
Li, Shangru [1 ]
Wu, Pengxia [1 ]
Wang, Rui [2 ]
Zhang, Chongfan [2 ]
Wu, Ye [1 ]
机构
[1] Peking Univ First Hosp, Dept Pediat, Beijing 100034, Peoples R China
[2] Fudan Univ, Childrens Hosp, GRADE Ctr, Shanghai 210102, Peoples R China
关键词
Myelin-oligodendrocyte glycoprotein antibody; associated disease; Azathioprine; Rituximab; Mycophenolate mofetil; Maintenance intravenous immunoglobulin; Tocilizumab; CLINICAL-COURSE; SPECTRUM; RESPONSES; CHILDREN;
D O I
10.1016/j.msard.2023.104571
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Approximately 40% of adults and 30% of children with Myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD) experience a relapsing course, but the optimal relapse prevention therapy remains unclear. A meta-analysis was conducted to investigate the efficacy of azathioprine (AZA), mycophe-nolate mofetil (MMF), rituximab (RTX), maintenance intravenous immunoglobulin (IVIG), and tocilizumab (TCZ) in prevention of attacks in MOGAD.Methods: English and Chinese-language articles published from January 2010 to May 2022 were searched in PubMed, Embase, Web of Science, Cochrane, Wanfang Data, China National Knowledge Infrastructure (CNKI), and China Science and Technology Journal Database (CQVIP). Studies with fewer than three cases were excluded. Meta-analysis of the relapse-free rate, the change of annualized relapse rate (ARR)and Expanded Disability Status Scale (EDSS) scores before and after treatment, and an age subgroup analysis was performed.Results: A total of 41 studies were included. Three were prospective cohort studies, one was an ambispective cohort study, and 37 were retrospective cohort studies or case series. Eleven, eighteen, eighteen, eight, and two studies were included in the meta-analysis for relapse-free probability after AZA, MMF, RTX, IVIG, and TCZ therapy, respectively. The proportions of patients without relapse after AZA, MMF, RTX, IVIG, and TCZ were 65% [95% confidence interval (CI):49%-82%]), 73% (95%CI:62%-84%), 66% (95%CI:55%-77%), 79% (95% CI:66%-91%), and 93% (95%CI:54%-100%), respectively. The relapse-free rate did not significantly differ be-tween the children and adults treated with each medication. Six, nine, ten, and three studies were included in the meta-analysis for the change of ARR before and after AZA, MMF, RTX, and IVIG therapy, respectively. ARR was significantly decreased after AZA, MMF, RTX, and IVIG therapy with a mean reduction of 1.58 (95%CI: [-2.29--0.87]), 1.32 (95%CI: [-1.57--1.07]), 1.01 (95%CI: [-1.34--0.67]), and 1.84 (95%CI: [-2.66--1.02]), respectively. The change in ARR did not significantly differ between children and adults.Conclusions: AZA, MMF, RTX, maintenance IVIG, and TCZ all reduce the risk of relapse in both pediatric and adult patients with MOGAD. The literatures included in the meta-analysis were mainly retrospective studies, so large randomized prospective clinical trials are needed to compare the efficacy of different treatments.
引用
收藏
页数:11
相关论文
共 50 条
[41]   Two Cases of Juvenile Myelomonocytic Leukemia and Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease [J].
Yamamoto, Hiroyuki ;
Natsume, Jun ;
Kaneko, Kimihiko ;
Takahashi, Toshiyuki ;
Wakamatsu, Manabu ;
Ogawa, Chikako ;
Kumai, Sumire ;
Suzui, Ryosuke ;
Sawamura, Fumi ;
Shiraki, Anna ;
Nakata, Tomohiko ;
Kidokoro, Hiroyuki ;
Muramatsu, Hideki ;
Takahashi, Yoshiyuki .
PEDIATRIC NEUROLOGY, 2023, 144 :1-4
[42]   Efficacy and safety of rituximab in myelin oligodendrocyte glycoprotein antibody-associated disorders compared with neuromyelitis optica spectrum disorder: a systematic review and meta-analysis [J].
Spagni, Gregorio ;
Sun, Bo ;
Monte, Gabriele ;
Sechi, Elia ;
Iorio, Raffaele ;
Evoli, Amelia ;
Damato, Valentina .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2023, 94 (01) :62-69
[43]   Pseudotumoural optic neuritis in myelin oligodendrocyte glycoprotein antibody-associated disease in children Pseudotumoural optic neuritis in MOG antibody-associated disease [J].
Roux, Julia ;
Bommier-Laur, Domitille ;
Calota, Mariana ;
Auvin, Stephane ;
Deiva, Kumaran .
ARCHIVES DE PEDIATRIE, 2025, 32 (02) :143-146
[44]   Recurrent ataxia and dysarthria in myelin oligodendrocyte glycoprotein antibody-associated disorder [J].
Chakraborty, Uddalak ;
Ghosh, Shrestha ;
Dana, Amlan Kusum ;
Chandra, Atanu .
BMJ CASE REPORTS, 2021, 14 (11)
[45]   The widening spectrum of myelin oligodendrocyte glycoprotein antibody-associated disorders in children [J].
O'toole, Orna .
DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY, 2019, 61 (05) :512-513
[46]   Oral corticosteroid dosage and taper duration at onset in myelin oligodendrocyte glycoprotein antibody-associated disease influences time to first relapse [J].
Trewin, Benjamin P. ;
Dale, Russell C. ;
Qiu, Jessica ;
Chu, Melissa ;
Jeyakumar, Niroshan ;
Dela Cruz, Fionna ;
Andersen, Jane ;
Siriratnam, Pakeeran ;
Ma, Kit Kwan M. ;
Hardy, Todd A. ;
van der Walt, Anneke ;
Lechner-Scott, Jeanette ;
Butzkueven, Helmut ;
Broadley, Simon A. ;
Barnett, Michael H. ;
Reddel, Stephen W. ;
Brilot, Fabienne ;
Kalincik, Tomas ;
Ramanathan, Sudarshini .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2024, 95 (11) :1054-1063
[47]   Comparative analysis of immunosuppressive therapies for myelin oligodendrocyte glycoprotein antibody-associated optic neuritis: a cohort study [J].
Xie, Lindan ;
Zhou, Huanfen ;
Song, Honglu ;
Sun, Mingming ;
Yang, Mo ;
Lai, Ying Meng ;
Xu, Quangang ;
Wei, Shihui .
BRITISH JOURNAL OF OPHTHALMOLOGY, 2022, 106 (11) :1587-1595
[48]   Clinical characteristics and prognosis of pediatric myelin oligodendrocyte glycoprotein antibody-associated diseases in China [J].
Xiaoang Sun ;
Meiyan Liu ;
Xiaona Luo ;
Fang Yuan ;
Chunmei Wang ;
Simei Wang ;
Quanmei Xu ;
Yuanfeng Zhang ;
Yucai Chen .
BMC Pediatrics, 22
[49]   Limbic Encephalitis in Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease: A Case Report and Literature Review [J].
Kaneko, Hiromi ;
Masuda, Teruaki ;
Yabuuchi, Kenichi ;
Nakamichi, Atsuhito ;
Mori, Toshio ;
Matsubara, Etsuro ;
Kimura, Noriyuki .
INTERNAL MEDICINE, 2025,
[50]   Complement Activation Profiles Predict Clinical Outcomes in Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease [J].
Villacieros-alvarez, Javier ;
Lunemann, Jan D. ;
Sepulveda, Maria ;
Valls-Carbo, Adrian ;
Dinoto, Alessandro ;
Fernandez, Victoria ;
Vilaseca, Andreu ;
Castillo, Mireia ;
Arrambide, Georgina ;
Bollo, Luca ;
Espejo, Carmen ;
Llufriu, Sara ;
Blanco, Yolanda ;
Armangue, Thais ;
Bravo, Gary Alvarez ;
Quiroga-Varela, Ana ;
Torrenta, Lluis Ramio ;
Cobo-Calvo, Alvaro ;
Tintore, Mar ;
Mariotto, Sara ;
Montalban, Xavier ;
Comabella, Manuel .
NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION, 2025, 12 (01)