Prevalence and Clinical Significance of Anti-MOG in the Cerebrospinal Fluid of Patients with Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease: A Systematic Review with Meta-Analysis
Gerardo Luna-Peralta1, Jeancarlo Ney Velazco-Muñoz1, Karlos Acurio2, Fritz Fidel Váscones-Román3, Guillermo Mantilla1, Ivan Alegre1, Carlos Quispe-Vicuña4
1Sociedad Científica de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Perú, 2Universidad Peruana Cayetano Heredia, Lima, Perú, 3Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú, 4Grupo de Investigación Neurociencias, Metabolismo, Efectividad Clínica y Sanitaria (NEMECS), Universidad Científica del Sur, Lima, Perú
Objective:
To summarize the current evidence on the prevalence and clinical significance of antibodies against myelin oligodendrocyte glycoprotein (MOG) in the cerebrospinal fluid (CSF) of patients with MOG antibody-associated disease (MOGAD).
Background:
Antibodies against MOG are essential for the current diagnostic criteria of MOGAD, but evidence regarding the prevalence and clinical utility of MOG antibodies in the CSF of these patients is scarce.
Design/Methods:
We searched five databases (PubMed, Embase, Scopus, Web of Science, and Google Scholar) up to September 2024. Observational studies evaluating anti-MOG antibody titers in the CSF of MOGAD patients were included. A meta-analysis using a random-effects model to estimate pooled effects was planned for each outcome, with a narrative synthesis provided when meta-analysis was not possible. The Newcastle-Ottawa scale was used to assess the risk of bias, and the GRADE criteria were applied to evaluate the certainty of evidence.
Results:
After selection, we included seven studies (642 participants). All studies demonstrated a low risk of bias. The overall prevalence of anti-MOG antibodies in the CSF of MOGAD patients was 74.0% (7 studies; 642 participants; 95% CI: 65.0%-83.0%; I² = 85%; CoE very low), with a higher prevalence in adults (79.0%; 4 studies; 370 participants; 95% CI: 63.0%-91.0%; I² = 89%; CoE very low) compared to children (68.0%; 3 studies; 272 participants; 95% CI: 62.0%-74.0%; I² = 0%; CoE very low). Additionally, 1 study reported an association between being anti-MOG seronegative + CSF positive and reaching an EDSS ≥ 3 with an OR of 4.8.
Conclusions:
We found that anti-MOG antibodies in the CSF are have positive titers in the majority of patients with MOGAD, with a higher prevalence in adults. However, the very low certainty of the evidence and the small number of studies suggest that further research is needed to corroborate these findings.
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