Evidence map›Paper›PMID 40712508›Full record

ArticleMultiple sclerosis and related disorders2025

Relapse and disability outcomes in incident MOGAD patients undergoing watchful waiting after onset.

Nanthaya Tisavipat, Adi Wilf-Yarkoni, Abdullah Al-Ani, Fiona Costello, Punchika Kosiyakul, Jiraporn Jitprapaikulsan, Niphon Chirapapaisan, Yoel Schwartzmann, Mark A Hellmann, Assaf Tolkovsky and 11 more

Abstract readMulticenter Study
In one paragraph

Article in Multiple sclerosis and related disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. MOGAD Is the Most Common Cause of Isolated Optic Neuritis in Children.Annals of clinical and translational neurology · 2026
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Nanthaya TisavipatDepartment of Neurology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA; Center for MS and Autoimmune Neurology, Mayo Clinic, USA.
Adi Wilf-YarkoniDepartment of Neurology, Rabin Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel.
Abdullah Al-AniSection of Ophthalmology, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Fiona CostelloSection of Ophthalmology, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Punchika KosiyakulSiriraj Neuroimmunology Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Jiraporn JitprapaikulsanSiriraj Neuroimmunology Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Niphon ChirapapaisanDepartment of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Yoel SchwartzmannUnit for Neuro-Immunology, Multiple Sclerosis & Cell Therapy, Department of Neurology, Hadassah Medical Center, Jerusalem, Israel.
Mark A HellmannDepartment of Neurology, Rabin Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel.
Assaf TolkovskyDepartment of Neurology, Rabin Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel.
Hadas Stiebel-KalishSackler Faculty of Medicine, Tel-Aviv University, Israel; Felsenstein Medical Research Center, Israel; Division of Neuro-Ophthalmology, Rabin Medical Center, Petah Tikva, Israel.
Esther Ganelin-CohenSackler Faculty of Medicine, Tel-Aviv University, Israel; Neuroimmunological Clinic, Institute of Pediatric Neurology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
Adi Vaknin-DembinskyFaculty of Medicine, Hebrew University of Jerusalem, Department of Neurology and Laboratory of Neuroimmunology, The Agnes-Ginges Center for Neurogenetics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Itay LotanDepartment of Neurology, Rabin Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel; Division of Neuroimmunology & Neuroinfectious Disease, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Michael LevyDivision of Neuroimmunology & Neuroinfectious Disease, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Rebecca SalkyDivision of Neuroimmunology & Neuroinfectious Disease, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Vyanka RedenbaughDepartment of Neurology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA; Center for MS and Autoimmune Neurology, Mayo Clinic, USA.
Alfonso S Lopez-ChiribogaCenter for MS and Autoimmune Neurology, Mayo Clinic, USA; Department of Neurology, Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA.
Sean J PittockDepartment of Neurology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA; Center for MS and Autoimmune Neurology, Mayo Clinic, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
Eoin P FlanaganDepartment of Neurology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA; Center for MS and Autoimmune Neurology, Mayo Clinic, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
John J ChenDepartment of Neurology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA; Center for MS and Autoimmune Neurology, Mayo Clinic, USA; Department of Ophthalmology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA. Electronic address: chen.john@mayo.edu.

Funding

Utilizing epidemiology, imaging and fluid biomarkers in MOG antibody-associated disease to inform prognosis, pathogenesis and therapeuticsR01NS113828 · NINDS · MAYO CLINIC ROCHESTER · PI Eoin P Flanagan · 2020 to 2026
$2.4M
NINDS NIH HHS R01 NS113828
6 · The paper itself

Abstract

backgroundObservation off chronic steroids-sparing immunotherapy (watchful waiting) is often recommended after the onset attack of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) given the variable relapse risk, but the outcomes of this approach are unexplored.

objectivesTo determine the risk of relapse and unfavorable disability outcomes in MOGAD patients who underwent watchful waiting approach after the onset attack.

methodsIn this international, multicenter, retrospective case series in four tertiary-care centers in Canada, Israel, Thailand, and the United States, patients who fulfilled the 2023 MOGAD diagnostic criteria, presented to the participating institutions with the first clinical attack (incident cases), and had at least 3 years of follow-up were identified (n = 81). Only incident cases were included to avoid referral bias.

resultsThe median age was 31 (IQR 18-47) years, 57 % were female, and the median follow-up was 6.3 (IQR 4.5-10.1) years. After onset, 65 (80 %) underwent watchful waiting. Forty-one (63 %) had relapses with annualized relapse rate of 0.27 (IQR 0.15-0.44). Unfavorable disability outcomes (Expanded Disability Status Scale score ≥2.0) were observed in 12/64 (19 %) watchful-waiting patients (7 from the onset attack; 4 from relapses; 1 unclear).

conclusionsGiven that one-third of watchful waiting patients remained monophasic and unfavorable disability outcomes from relapses were uncommon, a continued observation off chronic steroids-sparing immunotherapy could be an option for a subset of MOGAD patients.

Indexed as

Myelin Oligodendrocyte Glycoprotein Antibody-Associated DiseaseWatchful WaitingAdolescentAdultDisability EvaluationFemaleFollow-Up StudiesHumansMaleMiddle AgedRecurrenceRetrospective StudiesYoung AdultDisabilityMyelin oligodendrocyte glycoproteinOptic neuritisOutcomeTransverse myelitisTreatment

Identifiers

PMID40712508
PMCPMC12318300

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.