{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:43:52Z","timestamp":1792799032256,"version":"4.5.0"},"reference-count":40,"publisher":"BMJ","issue":"2","funder":[{"name":"The Petre Foundation","id":[{"id":"https:\/\/ror.org\/03p09fy30","id-type":"ROR","asserted-by":"crossref"}]},{"name":"The National Blood Authorit IVIg Grant","id":[{"id":"https:\/\/ror.org\/05c196m06","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Sydney Research Excellence Initiative 2020 Neuroimmunology Group"},{"name":"The National Blood Authority IVIg Grant","id":[{"id":"https:\/\/ror.org\/05c196m06","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000942","name":"Brain Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000942","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000924","name":"Multiple Sclerosis Research Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000924","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We characterised the clinical course, treatment and outcomes in 59 patients with relapsing myelin oligodendrocyte glycoprotein (MOG) antibody-associated demyelination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We evaluated clinical phenotypes, annualised relapse rates (ARR) prior and on immunotherapy and Expanded Disability Status Scale (EDSS), in 218 demyelinating episodes from 33 paediatric and 26 adult patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The most common initial presentation in the cohort was optic neuritis (ON) in 54% (bilateral (BON) 32%, unilateral (UON) 22%), followed by acute disseminated encephalomyelitis (ADEM) (20%), which occurred exclusively in children. ON was the dominant phenotype (UON 35%, BON 19%) of all clinical episodes. 109\/226 (48%) MRIs had no brain lesions. Patients were steroid responsive, but 70% of episodes treated with oral prednisone relapsed, particularly at doses &lt;10\u2009mg daily or within 2 months of cessation. Immunotherapy, including maintenance prednisone (P=0.0004), intravenous immunoglobulin, rituximab and mycophenolate, all reduced median ARRs on-treatment. Treatment failure rates were lower in patients on maintenance steroids (5%) compared with non-steroidal maintenance immunotherapy (38%) (P=0.016). 58% of patients experienced residual disability (average follow-up 61 months, visual loss in 24%). Patients with ON were less likely to have sustained disability defined by a final EDSS of \u22652 (OR 0.15, P=0.032), while those who had any myelitis were more likely to have sustained residual deficits (OR 3.56, P=0.077).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Relapsing MOG antibody-associated demyelination is strongly associated with ON across all age groups and ADEM in children. Patients are highly responsive to steroids, but vulnerable to relapse on steroid reduction and cessation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jnnp-2017-316880","type":"journal-article","created":{"date-parts":[[2017,11,15]],"date-time":"2017-11-15T12:20:54Z","timestamp":1510748454000},"page":"127-137","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":536,"title":["Clinical course, therapeutic responses and outcomes in relapsing MOG antibody-associated demyelination"],"prefix":"10.1136","volume":"89","author":[{"given":"Sudarshini","family":"Ramanathan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shekeeb","family":"Mohammad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Tantsis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina Kim","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Merheb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor S C","family":"Fung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen Bruce","family":"White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Broadley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannette","family":"Lechner-Scott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Vucic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew P D","family":"Henderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2156-8864","authenticated-orcid":false,"given":"Michael Harry","family":"Barnett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen W","family":"Reddel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabienne","family":"Brilot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell C","family":"Dale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,11,15]]},"reference":[{"key":"2020050722285293000_89.2.127.1","doi-asserted-by":"crossref","first-page":"4016","DOI":"10.4049\/jimmunol.139.12.4016","article-title":"A monoclonal antibody against a myelin oligodendrocyte glycoprotein induces relapses and demyelination in central nervous system autoimmune disease","volume":"139","author":"Schluesener","year":"1987","journal-title":"J Immunol"},{"key":"2020050722285293000_89.2.127.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-4159.1989.tb10930.x"},{"key":"2020050722285293000_89.2.127.3","doi-asserted-by":"publisher","DOI":"10.1038\/nm1488"},{"key":"2020050722285293000_89.2.127.4","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21916"},{"key":"2020050722285293000_89.2.127.5","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1001\/jamaneurol.2013.5857","article-title":"Neuromyelitis optica spectrum disorders with aquaporin-4 and myelin-oligodendrocyte glycoprotein antibodies: a comparative study","volume":"71","author":"Kitley","year":"2014","journal-title":"JAMA Neurol"},{"key":"2020050722285293000_89.2.127.6","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000040"},{"key":"2020050722285293000_89.2.127.7","doi-asserted-by":"publisher","DOI":"10.1177\/1352458514555785"},{"key":"2020050722285293000_89.2.127.8","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001729"},{"key":"2020050722285293000_89.2.127.9","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2011.2956"},{"key":"2020050722285293000_89.2.127.10","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000012"},{"key":"2020050722285293000_89.2.127.11","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1186\/s12974-016-0718-0","article-title":"MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. 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