PT  - JOURNAL ARTICLE
AU  - Liu, Jia
AU  - Mori, Masahiro
AU  - Zimmermann, Hanna
AU  - Brandt, Alexander
AU  - Havla, Joachim
AU  - Tanaka, Satoru
AU  - Sugimoto, Kazuo
AU  - Oji, Satoru
AU  - Uzawa, Akiyuki
AU  - Asseyer, Susanna
AU  - Cooper, Graham
AU  - Jarius, Sven
AU  - Bellmann-Strobl, Judith
AU  - Ruprecht, Klemens
AU  - Siebert, Nadja
AU  - Masuda, Hiroki
AU  - Uchida, Tomohiko
AU  - Ohtani, Ryohei
AU  - Nomura, Kyoichi
AU  - Meinl, Edgar
AU  - Kuempfel, Tania
AU  - Paul, Friedemann
AU  - Kuwabara, Satoshi
TI  - Anti-MOG antibody–associated disorders: differences in clinical profiles and prognosis in Japan and Germany
AID  - 10.1136/jnnp-2020-324422
DP  - 2020 Nov 17
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - jnnp-2020-324422
4099  - http://jnnp.bmj.com/content/early/2020/11/19/jnnp-2020-324422.short
4100  - http://jnnp.bmj.com/content/early/2020/11/19/jnnp-2020-324422.full
AB  - Background Neurological disorders with IgG antibodies against myelin-oligodendrocyte glycoprotein (MOG-IgG) have been increasingly recognised as a new type of neuroinflammatory disorder.Objective The study aimed to identify regional and ethnic differences in clinical profiles of MOG-IgG–associated disorders between East Asian (Japanese) and Caucasian (German) patients.Methods Demographic, clinical and therapeutic data from 68 MOG-IgG–positive adults were collected (Japanese, n=44; German, n=24).Results Age and sex were similar between cohorts, with optic neuritis occurring most frequently at onset (Japanese: 61%; German: 58%). However, Japanese patients had a lower annualised relapse rate (0.4 vs 0.8, p=0.019; no relapse, 64% vs 25%, p=0.002) and lower Expanded Disability Status Scale score at the last visit (1.0 vs 2.0; p=0.008), despite similar follow-up periods (mean, 73.9 months vs 73.4 months), than those of German patients, respectively. Cerebral syndromes were more common (27% vs 4%; p=0.021) and myelitis less common (21% vs 50%; p=0.012) in Japanese than in German patients, respectively. Japanese patients were more commonly treated with long-term corticosteroids (73%), whereas German patients were more commonly treated with rituximab or other immunosuppressants (63%).Conclusions Among patients with MOG-IgG, Japanese tended to have a monophasic milder disease, whereas the majority of German patients had a relapsing course and more frequent myelitis, findings compatible with neuromyelitis optica spectrum disorder. Although the attack-prevention treatment regimens were considerably different, genetic and environmental factors may be important to determine clinical phenotypes and disease activity.