Epidemiology of myelin oligodendrocyte glycoprotein antibody-associated disease: a review of prevalence and incidence worldwide

Abstract

Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is an inflammatory demyelinating disease of the central nervous system (CNS) with the presence of conformation-sensitive antibodies against MOG. The spectrum of MOGAD includes monophasic/relapsing optic neuritis, myelitis, neuromyelitis optica spectrum disorder (NMOSD) phenotype without aquaporin 4 (AQP4) antibodies, acute/multiphasic demyelinating encephalomyelitis (ADEM/MDEM)-like presentation, and brainstem and cerebral cortical encephalitis. There is no apparent female preponderance in MOGAD, and MOGAD can onset in all age groups (age at onset is approximately 30 years on average, and approximately 30% of cases are in the pediatric age group). While prevalence and incidence data have been available for AQP4+ NMOSD globally, such data are only beginning to accumulate for MOGAD. We reviewed the currently available data from population-based MOGAD studies conducted around the world: three studies in Europe, three in Asia, and one joint study in the Americas. The prevalence of MOGAD is approximately 1.3–2.5/100,000, and the annual incidence is approximately 3.4–4.8 per million. Among White people, the prevalence of MOGAD appears to be slightly higher than that of AQP4+ NMOSD. No obvious latitude gradient was observed in the Japanese nationwide survey. The data available so far showed no obvious racial preponderance or strong HLA associations in MOGAD. However, precedent infection was reported in approximately 20–40% of MOGAD cases, and this is worthy of further investigation. Co-existing autoimmune disorders are less common in MOGAD than in AQP4+ NMOSD, but NMDAR antibodies may occasionally be positive in patients with MOGAD. More population-based studies in different populations and regions are useful to further inform the epidemiology of this disease.

Myelin Oligodendrocyte Glycoprotein-Antibody Associated Disease: An Updated Review of the Clinical Spectrum, Pathogenetic Mechanisms and Therapeutic Management

“…Whilst mean age of onset is around the beginning of the fourth decade of life [ 6 , 13 , 14 ], MOG antibodies are not uncommonly associated with first demyelinating events in children, particularly acute demyelinating encephalomyelitis (ADEM) and optic neuritis (ON). In contrast to AQP4-NMOSD, which is more common in African American and Afro-Caribbean individuals, no particular racial preponderance has yet been identified in MOGAD [ 15 , 16 , 17 ]. Among young children (<10 years old), there is no difference between males and females; however, there is a slight female predominance in older children and adults (1.5:1), which is significantly less than the observed female predominance in AQP4 + NMOSD [ 16 , 18 ].…”

“…In contrast to AQP4-NMOSD, which is more common in African American and Afro-Caribbean individuals, no particular racial preponderance has yet been identified in MOGAD [ 15 , 16 , 17 ]. Among young children (<10 years old), there is no difference between males and females; however, there is a slight female predominance in older children and adults (1.5:1), which is significantly less than the observed female predominance in AQP4 + NMOSD [ 16 , 18 ].…”

Myelin oligodendrocyte glycoprotein antibody‐associated disorders: An overview

“…The prevalence of MOGAD varies but is approximately 1.3 to 2.5 per 100 000, and the annual incidence is approximately 3.4–4.8 per million 18 . There are several population‐based studies of the incidence per 100 000 persons: 0.12 in Malaysia, 19 0.4 in Brazil, 20 0.51 in Thailand, 21 0.52 in Quebec US, 22 1.34 in Japan, 23 and 2.5 in Italy 24 …”

Advancing Expertise in the Understanding of Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: Masterclass Event Summary

“…MOGAD is a rare CNS disease, which has only relatively recently been characterised as a separate entity to similar demyelinating conditions, such as MS and NMOSD. 1 Despite having overlapping characteristics, each of these diseases requires different treatment approaches, 1,2 and making the correct diagnosis is essential to quality patient care, the speakers said. The advancing expertise in the understanding of MOGAD masterclass looked at the latest research and trends related to the understanding of the condition, as well as advances in diagnostics and management.…”

“…Speakers started the day with an overview of MOGAD, a rare CNS inflammatory disorder with a global prevalence of 0.50-3.42 cases per 100,000 people. 1 They explained that demyelination associated with MOG antibodies can result in variable clinical presentations, including monophasic or recurrent episodes of optic neuritis, transverse myelitis, brainstem and cerebellar demyelinating attacks, monofocal or polyfocal cerebral deficit, and cerebral cortical encephalitis, with associated seizures. 2 The average age at onset is approximately 30 years, and around 30% of cases are in the paediatric age group.…”