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Journal: Frontiers in Neurology; August 21, 2020
Author(s): Susanna Asseyer, Graham Cooper, Friedemann Paul
A systematic review of pain in NMOSD and MOGAD
Pain is highly prevalent and debilitating in NMOSD and MOGAD with a severe impact on quality of life. Over 80% NMOSD and over 70% (estimated) MOGAD patients experience pain, including severe headache, eye pain, nerve pain (pins and needles, sensitivity to touch, burning sensations), muscular pain or spams, and pain from other autoimmune diseases that may coexist. This article reviews existing studies related to pain in NMOSD and MOGAD, including the pathogenesis and current treatment strategies. Acute pain due to optic neuritis seems to be particularly severe in MOGAD, while chronic neuropathic (nerve-related) pain is more severe in NMOSD. It does not suffice to treat the pain symptoms in isolation in NMOSD and MOGAD patients. Overall disease management with immunosuppressants tends to reduce pain. More holistic and effective pain-management strategies are needed.
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Journal: Neurology Neuroimmunology & Neuroinflammation; March 17, 2020
Author(s): Hyunjin Kim, Eun-Jae Lee, Seungmi Kim, Lyn-Kyung Choi, Keonwoo Kim, Hye Weon Kim, Kwang-Kuk Kim, Young-Min Lim
Blood parameters (serum biomarkers) in MOGAD
This study aimed to test the differences in patterns of serum biomarkers in MOGAD versus AQP4-seropositive NMOSD. Three serum biomarkers — neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), and tau — were compared between patients in relapse and remission states and cross-checked against disability index scores. The patterns of serum biomarkers in MOGAD showed distinct features from those in AQP4-seropositive NMOSD, which shows that these two diseases have different pathogeneses.
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Journal: Frontiers in Neurology; January 12, 2021
Author(s): Helen Cross, Farahna Sabiq, Nathalie Ackermans, Andrew Mattar, Shelly Au, Mark Woodhall, Bo Sun, Virginia Devonshire, Robert Carruthers, Ana Luiza Sayao, Virender Bhan, Alice Schabas, Jillian Chan, Marvin Fritzler, Patrick Waters, Anthony Traboulsee
A multi-ethnic Canadian group of patients testing positive for MOG antibodies
This study describes a multi-ethnic population of patients who tested positive for MOG antibodies at the University of British Columbia MS/NMO clinic. Patients who visited the clinic between 2005 and 2016, who were suspected to have NMOSD but did not test positive for anti-aquaporin4 antibodies, were retrospectively tested for MOG antibodies (retrospective group). The clinical data of all these patients and 20 MS patients as “controls” were reviewed retrospectively. Additional patients with MOG antibodies were identified through routine clinical interaction from 2016 through 2018 (prospective group). Two types of assays ̶ a live and a fixed cell-based was used to test for MOG antibodies. 21 of 146 patients in the retrospective cohort, 1 control, and 20 patients in the prospective cohort tested positive for MOG antibodies. The MOG antibody-positive patients in this multi-ethnic study showed similar characteristics to those discussed in previous studies, with some rarer features such as seizures. Many of these MOG-antibody positive patients relapsed and were left with significant disability. Positive anti-MOG antibodies can rule out MS in patients with an atypical clinical MS disease course.
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Journal: Journal of Neuroinflammation; May 3, 2018
Author(s): S. Jarius, F. Paul, O. Aktas, N. Asgari, R. C. Dale, J. de Seze, D. Franciotta, K. Fujihara, A. Jacob, H. J. Kim, I. Kleiter, T. Kümpfel, M. Levy, J. Palace, K. Ruprecht, A. Saiz, C. Trebst, B. G. Weinshenker & B. Wildemann
International recommendations on diagnosis and antibody testing in MOGAD
Before specific antibody tests for MOGAD became available, MOGAD was often misdiagnosed as MS or NMOSD. Since the introduction of these tests, many patients previously diagnosed with MS are now being tested for anti-MOG antibodies. To lessen the hazard of overdiagnosing MOGAD, which may lead to inappropriate treatment, more selective criteria for MOG antibody testing are urgently needed. This paper proposes indications for MOG antibody testing based on expert consensus and also shares a list of conditions atypical of MOGAD (red flags) that should prompt physicians to challenge a positive MOG-IgG test result.
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Journal: The Lancet Neurology; September 1, 2021
Author(s): Romain Marignier, Yael Hacohen, Alvaro Cobo-Calvo, Anne-Katrin Pröbstel, Orhan Aktas, Harry Alexopoulos, Maria-Pia Amato, Nasrin Asgari, Brenda Banwell, Jeffrey Bennett, Fabienne Brilot, Marco Capobianco, Tanuja Chitnis, Olga Ciccarelli, Kumaran Deiva, Jérôme De Sèze, Kazuo Fujihara, Anu Jacob, Ho Jin Kim, Ingo Kleiter, Hans Lassmann, Maria-Isabel Leite, Christopher Linington, Edgar Meinl, Jacqueline Palace, Friedemann Paul, Axel Petzold, Sean Pittock, Markus Reindl, Douglas Kazutoshi Sato, Krzysztof Selmaj, Aksel Siva, Bruno Stankoff, Mar Tintore, Anthony Traboulsee, Patrick Waters, Emmanuelle Waubant, Brian Weinshenker, Tobias Derfuss, Sandra Vukusic and Bernhard Hemmer
An overview of MOGAD
Myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a recently identified autoimmune disorder that can appear in both adults and children and is characterized by demyelination of the central nervous system. While it might appear similar to multiple sclerosis and NMOSD, cumulative biological, clinical, and pathological evidence indicates MOGAD to be a distinct disease. Patients who test positive for anti-MOG antibodies should not be diagnosed with multiple sclerosis or NMOSD. However, many questions related to the role of anti-MOG antibodies in the disease course of MOGAD remain unanswered, and more evidence is required regarding how and when to treat patients.
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Journal: The Lancet Neurology; November 10, 2020
Author(s): Michael Levy, Kazuo Fujihara and Jacqueline Palace
New therapies for NMOSD
Three therapies have recently been approved for neuromyelitis optica spectrum disorder (NMOSD): eculizumab, satralizumab, and inebilizumab. Four randomised controlled trials have tested the efficacy of these three new therapies and have shown a benefit in preventing future attacks. Efficacy, safety, tolerability, and practical considerations, including potential cost, differ for each drug and might affect the rate of use in real-world populations of patients with neuromyelitis optica spectrum disorder. Nevertheless, compared to the typical situation for rare diseases, these approved therapies represent an abundance of treatment options for NMOSD patients.
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Journal: Clinical Medicine Journal; March 1, 2019
Author(s): Saif Huda, Dan Whittam, Maneesh Bhojak, Jayne Chamberlain, Carmel Noonan, Anu Jacob and Rachel Kneen
A review of NMOSD
This article reviews the pathogenesis, clinical features, diagnosis and management of NMOSD. It includes a short patient case study and discusses the history, genetic factors and populations affected, clinical presentation, diagnostic considerations, and treatment options. Key take-home messages are as follows:
- Neuromyelitis optica spectrum disorder (NMOSD) is a relapsing central nervous system disease associated with aquaporin-4 antibodies.
- Common presentations include longitudinally extensive myelitis, severe optic neuritis, and area postrema syndrome.
- Prompt and aggressive treatment of relapses with high dose steroids with/without plasma exchange improves outcomes.
- All patients with aquaporin-4 antibodies should be immunosuppressed indefinitely to prevent further attacks.
- The NMOSD service based in Liverpool (Walton Centre NHS Foundation Trust) and Oxford (John Radcliffe Hospital) provides a quaternary service for all NMOSD patients in the UK. Referrals are accepted from GPs and all medical specialties.
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Journal: Multiple Sclerosis and Related Disorders; September 12, 2023
Author(s): Jianyi Liu, Xiaobo Zhang, Yi Zhong and Xianglin Liu
Prevalence of depression, anxiety, and sleep disturbances in a large group of NMOSD patients
Psychiatric disorders, such as depression, anxiety, and sleep disturbances, contribute substantially to the disease burden and reduce the health-related quality of life of NMOSD patients. This study assessed the prevalence of depression, anxiety, and sleep disturbances across 4213 NMOSD patients pooled from 31 different studies. The results showed a high prevalence of depression, anxiety, and sleep disturbances among NMOSD patients. This highlights the need for timely psychological monitoring and support for NMOSD patients.
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Journal: Journal of Managed Care & Specialty Pharmacy; December 1, 2022
Author(s): Dean M Wingerchuk, Brian G Weinshenker, Dana McCormick, Sasha Barron, Laura Simone and Larissa Jarzylo
Helping payers and treatment providers to understand and appropriately address the burden posed by NMOSD
This study reviewed previous studies to evaluate the disease burden, diagnosis, and treatment of NMOSD in the US. In addition, a patient survey was conducted to capture the real experiences of NMOSD patients. The authors found that the rarity of the condition combined with its similarities with disease like MS, can delay accurate diagnosis and treatment, increasing the chances of long-term disability. While several monoclonal antibodies have been approved for NMOSD treatment, there is limited evidence to guide treatment decision-making, including which therapies to use first, when to switch, and when to use them independently or in combination. The results of the patient survey revealed significant clinical and financial burdens to NMOSD patients, including frequent attacks, delays in therapy initiation, need for urgent care and repeat hospitalizations, new and worsening symptoms, accumulating disability, and difficulties affording care. The study provides recommendations for payers and treatment providers to consider these factors into their strategy for addressing the disease burden of NMOSD.
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Journal: Annals of Indian Academy of Neurology; January 11, 2022
Author(s): Varsha A Patil, Saurabh N Kamat, Jamshed A Lalkak and Bhim Singhal
Effectiveness and safety of rituximab in MS, NMOSD, and MOGAD
In this retrospective study of 61 MS, 37 NMOSD, and 4 MOGAD patients in India, rituximab treatment eliminated relapses in 97% of MS, 67% of NMOSD, and 50% of MOGAD patients over the study duration of June 2008 to January 2020. The disability scores improved in some MS patients but remained constant in NMOSD and MOGAD patients. The study concluded that rituximab is effective and safe in Indian patients with MS and NMOSD.
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