MOGAD treatment outcomes and relapse characteristics: Real-world experience from a Low-Middle income country
Journal: Multiple Sclerosis and Related Disorders; August 1, 2025
Author(s): Kshiteeja Jain, Kamakshi Dhamija, Vikram V Holla, K Thennarasu, Maya Bhat, Anita Mahadevan, M Netravathi
How MOGAD patients respond to azathioprine, mycophenolate mofetil, or rituximab: A study from India
This study looked at the number and frequency of relapses, if there are any relapse predictors, how disability progresses with relapses, and how well long-term immunotherapies work outside of controlled trials in 155 people (children and adults) with MOGAD treated at a major hospital in India.
Patients were on long-term treatment with azathioprine, mycophenolate mofetil, or rituximab. More than half of the patients experienced relapses, and relapses were more common in children. Patients with more frequent relapses tended to have greater disability over time, highlighting the importance of preventing relapses. Importantly, people whose disease began with myelitis (spinal cord inflammation) had a longer duration without relapse; this suggests that the type of first attack may influence the disease course.
All three commonly used long-term treatments evaluated were effective in lowering relapse rates and improving disability, regardless of age or type of symptoms. People with more attacks before starting treatment were more likely to relapse later, highlighting the importance of starting treatment early and continuing it.
These findings give useful real-world evidence about MOGAD treatment in low-middle income settings.
Related article: Efficacy and Safety of Rituximab in Central Nervous System Demyelinating Disorders (Indian context)
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