Results of a Survey on Diagnostic Procedures and Treatment Choices for Neuromyelitis Optica Spectrum Disorder in Korea: Beyond the Context of Current Clinical Guidelines

Lee, Hye Lim; Kim, Su‐Hyun; Seok, Jin Myoung; Kim, Byung Jo; Kim, Ho Jin; Kim, Byoung Joon

doi:10.3988/jcn.2022.18.2.207

Cited by 4 publications

(3 citation statements)

References 29 publications

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“…We found one patient with double seropositivity for MOG-Abs and AQP4-Abs, which is extremely rare [22,23]. She showed recurrent ON with asymptomatic brain lesions and was receiving satralizumab treatment, which is an uncommon treatment option in Korea [24]. Two incongruent cases and one double-seropositive case are presented in Supplemental Data Table S3.…”

Section: Discussionmentioning

confidence: 96%

Clinical Usefulness of a Cell-based Assay for Detecting Myelin Oligodendrocyte Glycoprotein Antibodies in Central Nervous System Inflammatory Disorders

Seok,

Waters,

Jeon

et al. 2023

Ann Lab Med

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Background: The clinical implications of myelin oligodendrocyte glycoprotein autoantibodies (MOG-Abs) are increasing. Establishing MOG-Ab assays is essential for effectively treating patients with MOG-Abs. We established an in-house cell-based assay (CBA) to detect MOG-Abs to identify correlations with patients' clinical characteristics.Methods: We established the CBA using HEK 293 cells transiently overexpressing fulllength human MOG, tested it against 166 samples from a multicenter registry of central nervous system (CNS) inflammatory disorders, and compared the results with those of the Oxford MOG-Ab-based CBA and a commercial MOG-Ab CBA kit. We recruited additional patients with MOG-Abs and compared the clinical characteristics of MOG-Ab-associated disease (MOGAD) with those of neuromyelitis optica spectrum disorder (NMOSD).Results: Of 166 samples tested, 10 tested positive for MOG-Abs, with optic neuritis (ON) being the most common manifestation (4/15, 26.7%). The in-house and Oxford MOG-Ab CBAs agreed for 164/166 (98.8%) samples (κ = 0.883, P < 0.001); two patients (2/166, 1.2%) were only positive in our in-house CBA, and the CBA scores of the two laboratories correlated well (r = 0.663, P < 0.001). The commercial MOG-Ab CBA kit showed one falsenegative and three false-positive results. The clinical presentation at disease onset differed between MOGAD and NMOSD; ON was the most frequent manifestation in MOGAD, and transverse myelitis was most frequent in NMOSD. Conclusions:The in-house CBA for MOG-Abs demonstrated reliable results and can potentially be used to evaluate CNS inflammatory disorders. A comprehensive, long-term study with a large patient population would clarify the clinical significance of MOG-Abs.

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Section: Discussionmentioning

confidence: 96%

Clinical Usefulness of a Cell-based Assay for Detecting Myelin Oligodendrocyte Glycoprotein Antibodies in Central Nervous System Inflammatory Disorders

Seok,

Waters,

Jeon

et al. 2023

Ann Lab Med

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Section: Discussionmentioning

confidence: 99%

“…Another survey about treatment choices performed in Korea before new treatments’ approval found that ISTs were prescribed by 85% of the 27 participating neurologists as first-line therapies, and 70% of them would switch to rituximab as second-line therapy if there was a relapse ( 35 ). Participants treating a higher number of NMOSD patients annually were more likely to prescribe rituximab as second-line therapy ( 35 ). Similarly, a higher volume of patients managed by the responding neurologist has been associated with lower TI in other studies in MS, as well as more years of experience or being an MS specialist ( 12 , 13 ).…”

Section: Discussionmentioning

confidence: 99%

Therapeutic inertia in the management of neuromyelitis optica spectrum disorder

Cobo-Calvo,

Gómez-Ballesteros,

Orviz

et al. 2024

Front. Neurol.

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Introduction and objectiveLimited information is available on how neurologists make therapeutic decisions in neuromyelitis optica spectrum disorder (NMOSD), especially when new treatments with different mechanisms of action, administration, and safety profile are being approved. Decision-making can be complex under this uncertainty and may lead to therapeutic inertia (TI), which refers to lack of treatment initiation or intensification when therapeutic goals are not met. The study aim was to assess neurologists’ TI in NMOSD.MethodsAn online, cross-sectional study was conducted in collaboration with the Spanish Society of Neurology. Neurologists answered a survey composed of demographic characteristics, professional background, and behavioral traits. TI was defined as the lack of initiation or intensification with high-efficacy treatments when there is evidence of disease activity and was assessed through five NMOSD aquaporin-4 positive (AQP4+) simulated case scenarios. A multivariate logistic regression analysis was used to determine the association between neurologists’ characteristics and TI.ResultsA total of 78 neurologists were included (median interquartile range [IQR] age: 36.0 [29.0–46.0] years, 55.1% male, median [IQR] experience managing demyelinating conditions was 5.2 [3.0–11.1] years). The majority of participants were general neurologists (59.0%) attending a median (IQR) of 5.0 NMOSD patients (3.0–12.0) annually. Thirty participants (38.5%) were classified as having TI. Working in a low complexity hospital and giving high importance to patient’s tolerability/safety when choosing a treatment were predictors of TI.ConclusionTI is a common phenomenon among neurologists managing NMOSD AQP4+. Identifying TI and implementing specific intervention strategies may be critical to improving therapeutic decisions and patient care.

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Serum neurofilament and glial fibrillary acidic protein in idiopathic and seropositive transverse myelitis

Lee,

Seok,

Chung

et al. 2023

Multiple Sclerosis and Related Disorders

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Results of a Survey on Diagnostic Procedures and Treatment Choices for Neuromyelitis Optica Spectrum Disorder in Korea: Beyond the Context of Current Clinical Guidelines

Cited by 4 publications

References 29 publications

Clinical Usefulness of a Cell-based Assay for Detecting Myelin Oligodendrocyte Glycoprotein Antibodies in Central Nervous System Inflammatory Disorders

Clinical Usefulness of a Cell-based Assay for Detecting Myelin Oligodendrocyte Glycoprotein Antibodies in Central Nervous System Inflammatory Disorders

Therapeutic inertia in the management of neuromyelitis optica spectrum disorder

Serum neurofilament and glial fibrillary acidic protein in idiopathic and seropositive transverse myelitis

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