2025 American Academy of Neurology Abstract Website

Objective:

Background:

Anti-myelin oligodendrocyte glycoprotein immunoglobulin G antibody-associated disease (MOGAD) is a rare autoimmune disease of the central nervous system. Currently, there are limited data from MOGAD treatment studies. The acute phase treatment regimens for MOGAD are hormones, human immunoglobulin and plasma exchange, and the remission phase treatment regimens are low-dose hormones, Azathioprine, Mycophenolate Mofetil, Rituximab and Methotrexate. Satralizumab is an anti-interleukin-6 receptor monoclonal antibody. To date, no studies have reported Satralizumab as adjuvant therapy in patients with MOGAD.

Design/Methods:

The patient was a 12-year-old Chinese female with a history of more than 7 infammatory episodes (clinical attacks) over 4 years. At the age of 8 (December 2019), she developed acute left optic neuritis. Ten months later，she reported visual impairment in her right eye，The results of the MOG antibody test by cell-based assay were positive in both serum (titer, 1:32) and CSF (titer, 1:32). she was administered high-dose intravenous methylprednisolone followed by oral prednisone . In December 2021, the child developed headache, generalized tonic-clonic seizures, aphasia, and limb weakness after an upper respiratory tract infection. She was given human immunoglobulin and methylprednisolone, followed by 45mg of prednisone acetate orally, 0.75g of MMF was added, hormone was reduced by 5mg per month, and MMF was added to 1g/ day after 3 months. The patient's clinical symptoms were completely relieved. After that, she patients experienced disease recurrence whenever prednisone acetate was reduced to less than 20mg/ day. Due to poor treatment response and to prevent relapse further, patients received Satralizumab as adjuvant therapy to oral prednisone, administered subcutaneously at a dose of 120 mg at weeks 0, 2, and 4 and every 4 weeks thereafter.

Results:

After starting Satralizumab, patient remained relapse-free for 9 months at last follow-up.

Conclusions:

Satralizumab may be effective and safe as adjuvant therapy in patients with MOGAD at high risk of relapse.