Figure 6 shows the popularity of each drug as a first-, second- or third-line treatment following breakthrough relapses. Open in a separate window Fig. first collection MT (54.5%; 6/11). Treatment response is usually monitored by MRI (53.8%; 28/52), optical coherence tomography (23.1%; 12/52) and MOG antibody titres (36.5%; 19/52). Regardless of monitoring results, 25.0% (13/52) would not stop MT. Conclusion Current treatment of MOGAD is usually highly variable, indicating a need for consensus-based treatment guidelines, while awaiting definitive clinical trials. Keywords: Myelin oligodendrocyte glycoprotein, MOG, MOGAD, Survey Introduction Myelin oligodendrocyte glycoprotein antibody associated disorders (MOGAD) have been widely recognised as a distinct clinical entity only in the last decade, following the development of reliable cell-based assays using full-length human MOG as the target antigen [1, 2]. They encompass monophasic and relapsing presentations of central demyelination. Within the neuromyelitis optica phenotype, optic neuritis is usually more common than transverse myelitis [3C8]. The clinical spectrum has since expanded to include brainstem and cortical encephalitis [9C12]. The EPZ031686 most frequent presentation in young children is usually acute disseminated encephalomyelitis (ADEM) [8, 12, 13]. In comparison to aquaporin-4 antibody positive EPZ031686 neuromyelitis optica spectrum disorders (AQP4-Ab NMOSD), relapse is usually less common. Approximately half of MOGAD patients may have monophasic disease, but some experience frequent relapses despite immunosuppressive therapy [14C17]. The value of antibody titres in predicting relapse is not yet fully comprehended. Overall, motor and visual disability outcomes seem better in MOGAD than in AQP4-Ab NMOSD [5, 14, 17], but the impact of relapses on long-term disability is usually unclear. The unpredictability of MOGAD presents a challenge when developing treatment paradigms. Retrospective studies suggest that both acute and maintenance immunotherapy improve outcomes. However, you will find no randomised controlled trials (RCTs) in MOGAD and an international, evidence-based consensus on management is usually yet to be developed. The objective of this survey is usually to describe the current clinical practice of neurologists treating adults and children with MOGAD internationally, to identify common themes, divergent practices and unanswered questions, which could inform the planning of collaborative studies and clinical trials. Methods The survey was created with the Survey Monkey web-based tool (https://www.surveymonkey.co.uk). It comprised a mix of 34 multiple choice, rating, or free-text questions (observe online supplementary material). Eighty-six neurologists were invited to participate via email. Invites were sent out to prospective attendees at the 7th Focused Workshop of The European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) on MOGAD, which took place on 7thC8th March 2019, in Athens, Greece. The survey was closed to meeting attendees on 6th March to avoid obtaining biased responses following the getting together with. Additional neurologists blinded to the workshop discussions and conclusions were invited to total the survey, with the aim of creating a diverse global Rabbit polyclonal to AACS representation. All responses were obtained throughout February to April 2019. Results A. Respondent details and scope of practice Fifty-two responses were received (response rate 60.5%) from neurologists practising in 22 countriesArgentina (1), Australia (4), Brazil (1), Canada (2), China (1), Denmark/Hungary (1), France (3), French Martinique (1), Germany (5), Italy (4), India EPZ031686 (1), Japan (2), Malaysia (2), Netherlands (1), Republic of Korea (1), Spain (1), Switzerland (1), Thailand (1), EPZ031686 Turkey (3), United Kingdom (7) and United States of EPZ031686 America (9). Respondents were adult (78.8%, 41/52) and paediatric (21.2%, 11/52) neurologists, with 43.9% (18/41) of adult neurologists also involved in the.