{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:06:24Z","timestamp":1792202784460,"version":"4.4.0"},"reference-count":42,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n The impact of late onset in myelin oligodendrocyte glycoprotein antibody\u2013associated disease (MOGAD) is still controversial.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate the association of late onset MOGAD with moderate disability and relapse in Korean patients.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This nationwide, multicenter, retrospective cohort study included adult patients with a diagnosis of MOGAD according to the 2023 international diagnostic criteria between August 2018 and September 2024 across 28 hospitals in South Korea.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Age at onset of MOGAD, categorized into adult-onset MOGAD (AO-MOGAD; 18-49 years) and late-onset MOGAD (LO-MOGAD; \u226550 years).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcomes were time to first relapse in patients with a disease duration of 12 or more months and moderate disability, defined as Expanded Disability Status Scale (EDSS) score of 3 or greater at last follow-up.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 350 patients (mean [SD] age at onset, 43.2 [15.0] years; 189 female [54.0%]) with a median (IQR) baseline EDSS of 3.0 (2.0-4.0) were included, with 124 patients (35.4%) with LO-MOGAD and 226 patients (64.6%) with AO-MOGAD. The LO-MOGAD group had less frequent brain involvement than the AO-MOGAD group at onset (26 patients [21.0%] vs 75 patients [33.2%];\n P<\/jats:italic>\n \u2009=\u2009.02) and during the disease course (28 patients [22.6%] vs 95 patients [42.0%];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), while optic neuritis or myelitis was comparable between the 2 groups. The LO-MOGAD group showed more frequent monophasic course (55 of 95 patients [57.9%] vs 75 of 188 patients [39.9%];\n P<\/jats:italic>\n \u2009=\u2009.004), but higher EDSS score at last follow-up (median [IQR], 2.0 [1.0-2.0] vs 1.0 [0.0-2.0];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) compared with those in the AO-MOGAD group. However, late onset was not significantly associated with the time to first relapse in multivariable analysis (adjusted hazard ratio, 0.72; 95% CI, 0.48-1.08;\n P<\/jats:italic>\n \u2009=\u2009.11), which was consistent after propensity score matching. By contrast, late onset was associated with a significantly higher risk of moderate disability at the last follow-up (adjusted odds ratio, 2.84; 95% CI, 1.39-5.80;\n P<\/jats:italic>\n \u2009=\u2009.004).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of MOGAD, late onset was not associated with a risk of relapse but with a higher risk of moderate disability at follow-up. Prospective studies with longer follow-up periods are warranted to better understand and manage patients with late-onset disease.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.59471","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T16:30:25Z","timestamp":1771000225000},"page":"e2559471","source":"Crossref","is-referenced-by-count":2,"title":["Disability and Relapse Risk in Late-Onset Myelin Oligodendrocyte Glycoprotein Antibody\u2013Associated Disease"],"prefix":"10.1001","volume":"9","author":[{"given":"Hyunjin","family":"Ju","sequence":"first","affiliation":[{"name":"Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"},{"name":"Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ki 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Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunjin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun-Jae","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Min","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of 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