Persistent MOG-IgG titers associated with higher relapse risk in pediatric MOGAD cohort

This retrospective cohort study analyzed 63 children with MOG antibody-associated disease (MOGAD) to investigate the relationship between serum MOG-IgG titer status and prognosis. The study compared outcomes between groups defined by titer persistence (transient positive vs. continuous positive), titer levels (low vs. high), and disease course (monophasic vs. relapsing). The primary outcome was disease relapse, with secondary outcomes of long-term prognosis and time to negative MOG-IgG titers.

Children with persistent positive MOG-IgG titers had a higher probability of relapse (P = 0.030) and a higher number of relapses (P = 0.024) compared to those with transient positive titers. Persistent positive titers were also associated with poor long-term prognosis (P = 0.013). In a separate analysis, the time to negative MOG-IgG titers was shorter in the monophasic course group compared to the relapsing group (P < 0.05). The study did not report specific absolute numbers or effect sizes for these associations.

Safety and tolerability data were not reported. Key limitations include the retrospective, observational design, which cannot establish causation, and the lack of reported effect sizes, absolute risk numbers, and follow-up duration. Funding sources and conflicts of interest were also not reported. For clinical practice, these findings suggest an association between persistent MOG-IgG seropositivity and a more relapsing disease course in children, but the evidence remains observational and requires prospective validation.