NMOSD and MOGAD in Latin America: A consensus-informed regional perspective
Journal: Multiple Sclerosis and Related Disorders; October 1, 2026
Author(s): Vinícius Boldrinia, Sara Samadzadeh, Edgar Carnero Contentti, Vitória Pimentel, Natalia Szejko, Ethel Ciampil, Jacqueline Palace, Friedemann Paul, Jefferson Becker, Alfredo Damasceno, ECF Young Investigators/Fellows Initiative
NMOSD and MOGAD in Latin America: diagnosis, treatment, and associated challenges
This paper brings together data from many published studies, along with opinions from a group of experts, to present the current status of NMOSD and MOGAD in Latin America (LATAM). The study looked at how common these conditions are, how they are diagnosed and treated, and the barriers patients face in accessing appropriate care. The goal of this paper is to identify priorities to improve diagnosis and treatment of these conditions in Latin America.
Recent studies have tried to identify how commonly NMOSD and MOGAD occur in Latin America, but all these studies present different estimates of because of differences in diagnostic methods used across the region. The main challenges that prevent these conditions from being managed as best as possible across the region are:
• delays in diagnosis,
• conditions being misclassified as other diseases,
• patients not having equal access to specialized neuroimmunology services,
• considerable differences in the methods used for antibody testing, and
• lack of access to newer therapies.
In one study involving 496 patients from specialized MS/NMOSD referral centers in LATAM, 56 patients (12%) were initially misdiagnosed. In fact, about 34% of the initial misdiagnoses had been made by MS/NMOSD specialists. Multiple sclerosis was the most common incorrect diagnosis. Among these misdiagnosed patients, more than half had seen at least two neurologists before receiving the correct diagnosis of NMOSD, and the average delay was about 5.5 years.
Accurate testing for aquaporin4 (AQP4) antibodies for NMOSD and MOG antibodies for MOGAD is important for timely diagnosis and treatment. Live cell-based assays are generally considered the most reliable tests for antibody testing, but they are available locally at only a limited number of specialized centers in LATAM. Commercial fixed cell-based tests are more widely available, but they may vary in accuracy.
As of June 2025, fewer than 5% of NMOSD patients who tested positive for AQP4 antibodies from LATAM’s largest studies across several treatment centers were receiving inebilizumab, satralizumab, or eculizumab.
The study authors identified two main priorities for NMOSD and MOGAD care in the LATAM region:
1. Expanding access to live cell-based assays for diagnosis
2. Improving access to newer highly effective therapies
Related article: https://www.sumairafoundation.org/summaries/unmet-needs-in-the-care-of-patients-with-neuromyelitis-optica-spectrum-disorder-and-myelin-oligodendrocyte-glycoprotein-antibody-associated-disease-insights-from-germany/
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