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Background <p>Predicting relapses in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) when disability is relapse-dependent is crucial to guide treatment decisions including whether to treat from onset. MOG-AR, a relapse risk score, was recently developed in a Chinese cohort from disease onset. This study aimed to externally validate the MOG-AR score.</p> Methods <p>MOGAD patients seen through the Oxford National NMO Service with ≥ 1-year disease duration and available data for MOG-AR score calculation (variables of age, sex, onset attack phenotype, treatment) were included. MOG-AR score and grade were calculated. Relapse occurrence at 3 years from onset was used as the primary outcome. MOG-AR performance was assessed by measures of discrimination and calibration.</p> Results <p>We included 284 MOGAD patients with a 4.7-year median disease duration. Relapse occurred in 38% within 3 years of onset. Median MOG-AR score and grade were 11 (IQR 10–12) and 3 (3–3) for those who relapsed and 9 (8–11) and 3 (2–3) for those who did not. Observed proportion with relapse was 27%, 26%, 41%, and 53% for grades 1, 2, 3, and 4, respectively. Discrimination assessment by grade showed an area under the receiver operating characteristic curve of 0.58 (95% CI 0.52–0.63). Calibration assessment was consistent with overestimation of relapse probabilities.</p> Conclusion <p>In a UK-MOGAD cohort, MOG-AR score showed suboptimal performance in predicting relapse over a 3-year period from onset. Further work to find clinically accessible predictive biomarkers and tools for a relapsing course would facilitate better treatment strategies near disease onset.</p>

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Prediction of relapse in myelin oligodendrocyte glycoprotein antibody-associated disease: external validation of the MOG-AR score

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月23日

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  • Wei Zhen Yeh,
  • Anna Francis,
  • Helmut Butzkueven,
  • Ruth Geraldes,
  • Maria Isabel Leite,
  • Jacqueline Palace

摘要

Background

Predicting relapses in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) when disability is relapse-dependent is crucial to guide treatment decisions including whether to treat from onset. MOG-AR, a relapse risk score, was recently developed in a Chinese cohort from disease onset. This study aimed to externally validate the MOG-AR score.

Methods

MOGAD patients seen through the Oxford National NMO Service with ≥ 1-year disease duration and available data for MOG-AR score calculation (variables of age, sex, onset attack phenotype, treatment) were included. MOG-AR score and grade were calculated. Relapse occurrence at 3 years from onset was used as the primary outcome. MOG-AR performance was assessed by measures of discrimination and calibration.

Results

We included 284 MOGAD patients with a 4.7-year median disease duration. Relapse occurred in 38% within 3 years of onset. Median MOG-AR score and grade were 11 (IQR 10–12) and 3 (3–3) for those who relapsed and 9 (8–11) and 3 (2–3) for those who did not. Observed proportion with relapse was 27%, 26%, 41%, and 53% for grades 1, 2, 3, and 4, respectively. Discrimination assessment by grade showed an area under the receiver operating characteristic curve of 0.58 (95% CI 0.52–0.63). Calibration assessment was consistent with overestimation of relapse probabilities.

Conclusion

In a UK-MOGAD cohort, MOG-AR score showed suboptimal performance in predicting relapse over a 3-year period from onset. Further work to find clinically accessible predictive biomarkers and tools for a relapsing course would facilitate better treatment strategies near disease onset.