The goal of this study is to characterize the clinical course of patients with Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD) who seroconvert from a positive to negative MOG antibody status, and to determine predictors of seroconversion.  

MOGAD is a neuroinflammatory disorder characterized by demyelination of the optic nerve, brain, or spinal cord, and can be either relapsing or monophasic. Persistent MOG antibody positivity has been identified as a potential predictor of disease-related relapses, however there has been limited research regarding what determines whether patients remain seropositive or convert to a negative MOG antibody status.

We identified 66 patients who had at least 2 MOG antibody tests 6 months apart (60.6% females and 39.4% males). Of these, 47 had persistently positive MOG titers, and 18 had positive titers that became negative. 5 individuals had negative titers that later converted to positive. Of the 18 patients that developed negative titers, only 1 had a subsequent documented relapse, which was associated with discontinued immunotherapy and titers which became positive again at the time of relapse. Predictors of conversion to negative IgG on multivariate logistic regression included low initial MOG titers (defined as titers <1:100), male sex, and childhood onset of disease.  

Low initial MOG titers, male sex, and childhood onset of disease can help predict future conversion to negative MOG serostatus. Further analysis of this cohort will focus on the effect of various immunotherapies and their timing on MOG antibody status.