Evidence map›Paper›PMID 42440328›Full record

ArticleJAMA neurology2026

Interleukin 6 Receptor Blockade for Relapse Prevention in Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease.

Andreu Vilaseca, Philippe A Bilodeau, Georgios Gakis, Andrea Savransky, Joao Mahler Ferreira Oliveira, Linda Nguyen, Sam I Hooshmand, Sammita Satyanarayan, Carson E Moseley, Leah Haley and 48 more

Abstract readMulticenter Study
In one paragraph

Article in JAMA neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

58 authors.

Andreu VilasecaDepartment of Neurology and Center for MS and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota.
Philippe A BilodeauMassachusetts General Hospital and Harvard Medical School, Boston.
Georgios GakisDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Andrea SavranskyPaediatric Neuroimmunology Clinic, Department of Neurology, National Paediatric Hospital Dr J P Garrahan, Ciudad de Buenos Aires, Argentina.
Joao Mahler Ferreira OliveiraMassachusetts General Hospital and Harvard Medical School, Boston.
Linda NguyenDepartment of Neurology, University of Texas Southwestern Medical Center, Dallas.
Sam I HooshmandDepartment of Neurology, Medical College of Wisconsin, Milwaukee.
Sammita SatyanarayanCorinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York.
Carson E MoseleyDepartment of Neurology, Weill Institute for Neurosciences, University of California, San Francisco.
Leah HaleyDepartment of Neurology, New York University Langone Medical Centre, New York, New York.
Chantal Roy-HewitsonDepartment of Neurological Sciences, Larner College of Medicine at the University of Vermont, Burlington.
Mariano MarrodanDepartment of Neurology, Fleni, Buenos Aires, Argentina.
Adriana CasallasCayre Multiple Sclerosis Center, Bogotá, Colombia.
Analisa ManinCentro Argentino de Neuroinmunología (CADENI), Hospital General de Agudos José María Ramos Mejía, Buenos Aires, Argentina.
Haiwen ChenDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Yoji HoshinaDepartment of Neurology, University of Utah, Salt Lake City.
Aniela GrzezulkowskaDepartment of Neurology, University of Iowa Hospitals and Clinics, Iowa City.
Edgar Carnero ContenttiNeuroimmunology Unit, Department of Neurosciences, Hospital Aleman, Buenos Aires, Argentina; CENRos, Neuroimmunology Clinic, INECO Neurociencias Oroño, Rosario, Argentina.
Lorna GalleguillosNeuroimmunology Unit, Department of Neurology and Psychiatry, Clinica Alemana of Santiago, Chile.
Margaret UpchurchDepartments of Neurology and Ophthalmology, Programs in Neuroscience and Immunology, University of Colorado Anschutz School of Medicine, Aurora.
Caitlin S Jackson-TarltonDepartment of Medicine, Division of Neurology, Dalhousie University, Halifax, Nova Scotia, Canada.
Joanne Chu-Yueh GuoDepartment of Neurology, Weill Institute for Neurosciences, University of California, San Francisco.
Michelle FabianCorinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York.
Akash VirupakshaiahDepartment of Neurology, Weill Institute for Neurosciences, University of California, San Francisco.
Georgina ArrambideNeurology-Neuroimmunology Department, Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d'Hebron Barcelona Hospital Campus.
César Caparó-ZamalloaCentro Básico de Investigación en Demencia y enfermedades desmielinizantes del SNC, Instituto Nacional de Ciencias Neurológicas, Lima, Perú.
Rafael PaternoIrmandade da Santa Casa de São Paulo, Serviço de Neurologia, São Paulo SP, Brazil.
Emmanuelle WaubantDepartment of Neurology, Weill Institute for Neurosciences, University of California, San Francisco.
Laura Ordoñez BoschettiDepartment of Neurology, Hospital Español de Mexico, Mexico City, Mexico.
Jorge CorrealeDepartment of Neurology, Fleni, Buenos Aires, Argentina.
Andres M VillaCentro Argentino de Neuroinmunología (CADENI), Hospital General de Agudos José María Ramos Mejía, Buenos Aires, Argentina.
Brenda BanwellDepartment of Pediatrics, Johns Hopkins University, Maryland.
Romain MarignierService de neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, and Centre de Référence des Maladies Inflammatoires Rares du Cerveau et de la Moelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Centre de Recherche en Neurosciences de Lyon, Lyon, France; Université Claude Bernard Lyon, Lyon, France.
Sean J PittockDepartment of Neurology and Center for MS and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota.
Benjamin GreenbergDepartment of Neurology, University of Texas Southwestern Medical Center, Dallas.
Jeffrey L BennettDepartments of Neurology and Ophthalmology, Programs in Neuroscience and Immunology, University of Colorado Anschutz School of Medicine, Aurora.
Tracey ChoDepartment of Neurology, University of Iowa Hospitals and Clinics, Iowa City.
Stacey ClardyDepartment of Neurology, University of Utah, Salt Lake City.
Andrew J SolomonDepartment of Neurological Sciences, Larner College of Medicine at the University of Vermont, Burlington.
Ilya KisterDepartment of Neurology, New York University Langone Medical Centre, New York, New York.
Scott S ZamvilDepartment of Neurology, Weill Institute for Neurosciences, University of California, San Francisco.
Jeffrey M GelfandDepartment of Neurology, Weill Institute for Neurosciences, University of California, San Francisco.
Pavle RepovicDepartment of Neurology, Swedish Medical Center, Seattle, Washington.
Ahmed Z ObeidatDepartment of Neurology, Medical College of Wisconsin, Milwaukee.
Kyle BlackburnDepartment of Neurology, University of Texas Southwestern Medical Center, Dallas.
Silvia TenembaumPaediatric Neuroimmunology Clinic, Department of Neurology, National Paediatric Hospital Dr J P Garrahan, Ciudad de Buenos Aires, Argentina.
John J ChenDepartment of Neurology and Center for MS and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota.
Elias S SotirchosDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Michael LevyMassachusetts General Hospital and Harvard Medical School, Boston.
Eoin P FlanaganDepartment of Neurology and Center for MS and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota.
and The Americas MOGAD Treatment Group
Fabian MurilloMassachusetts General Hospital and Harvard Medical School, Boston.
Stephanie B Syc-MazurzekDepartment of Neurology and Center for MS and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota.
Laura CacciaguerraDepartment of Neurology and Center for MS and Autoimmune Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota.
Mulan JiangMassachusetts General Hospital and Harvard Medical School, Boston.
Nathane Braga da Silva RezendeDepartment of Internal Medicine (Clinical Medicine), School of Medicine, Universidad de Estácio de Sá, Rio de Janeiro, Brasil.
Dean M WingerchukDepartment of Neurology, Mayo Clinic College of Medicine, Scottsdale, Arizona.
Susan E HorsmanPharmacy Department, Mayo Clinic College of Medicine, Rochester, Minnesota.

Funding

Child Neurologist Career Development Program (CNCDP)K12NS098482 · NINDS · HUGO W. MOSER RES INST KENNEDY KRIEGER · PI SCHLAGGAR, BRADLEY L · 2016 to 2025
$26.2M
Characterization of T cells in MOG antibody-associated diseaseR01AI170863 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SCOTT S ZAMVIL · 2023 to 2026
$3.2M
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
NIAID NIH HHS R01 AI170863NINDS NIH HHS K12 NS098482NINDS NIH HHS R01 NS113828
6 · The paper itself

Abstract

Importance: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) lacks proven relapse-preventive therapies. While clinical trials are ongoing, safety data may be limited and approved drugs are costly. Studies of interleukin 6 receptor blocker (IL-6RB) in MOGAD are limited by small numbers and no comparative studies, contributing to low use. Objective: To evaluate the impact of IL-6RB therapy on relapse rates in MOGAD and compare relapse frequency with intravenous immunoglobulin (IVIG). Design, Setting, and Participants: This international, multicenter, retrospective cohort study (January 1, 2015, through December 31, 2025) included a historical IVIG-treated cohort of varying doses. The study took place across sites in North and South America (US, Canada, Mexico, Argentina, Brazil, Chile, Colombia, and Peru). Patients with MOGAD (n = 116, no excluded patients) who received at least 1 dose of an IL-6RB were included. These data were analyzed in January 2026. Exposures: Tocilizumab or satralizumab. Main Outcomes and Measures: Annualized relapse rate (ARR) during IL-6RB therapy, time to next relapse after treatment initiation, and adverse events. Outcomes were compared with the IVIG cohort using inverse probability of treatment weighting (IPTW) adjusted for age, sex, prior ARR, and concomitant therapies. Results: A total of 116 patients with MOGAD (89% relapsing) receiving IL-6RB (tocilizumab, 104 [90%] and satralizumab, 12 [10%]) were included; overall, 60.3% were female, 39.7% were male, and 18% were younger than 18 years. The median (IQR) IL-6RB treatment follow-up was 1.4 (0.7-2.5) years and 23 relapses occurred during 241.8 person-years of IL-6RB therapy. The ARR decreased from 0.64 (95% CI, 0.58-0.70) for relapsing MOGAD before IL-6RB to 0.09 (95% CI, 0.06-0.14) during IL-6RB treatment (incidence rate ratio, 0.08; 95% CI, 0.04-0.16). Adverse events occurred in 58 patients (50%), most commonly mild infections, although 10 (9%) had severe infections. In the IVIG cohort (n = 59), 30 relapses occurred over 133.8 person-years (ARR, 0.22; 95% CI, 0.15-0.32). After IPTW, IL-6RB was associated with a lower hazard ratio (HR) than the group who underwent IVIG therapy less than 1 g/kg every 4 weeks (HR, 4.5; 95% CI, 2.0-9.8), with no significant difference vs the group who underwent IVIG 1 g/kg or more every 4 weeks (HR, 2.0; 95% CI, 0.8-4.5). Conclusions and Relevance: In this multicenter observational cohort, IL-6RB use in MOGAD was associated with low relapse rates and a favorable safety profile, though severe infections occurred occasionally. Relapse rates were lower than the group who underwent IVIG less than 1 g/kg every 4 weeks but not significantly different from the group who underwent IVIG 1 g/kg or more every 4 weeks. This supports IL-6RB as a potential relapse-prevention therapy in MOGAD; the wide availability and relative affordability of tocilizumab may enable broad global use.

Indexed as

Antibodies, Monoclonal, HumanizedMyelin Oligodendrocyte Glycoprotein Antibody-Associated DiseaseReceptors, Interleukin-6Secondary PreventionAdultCohort StudiesFemaleHumansImmunoglobulins, IntravenousMaleMyelin-Oligodendrocyte GlycoproteinRecurrenceRetrospective StudiesYoung AdultAntibodies, Monoclonal, HumanizedImmunoglobulins, IntravenousMyelin-Oligodendrocyte GlycoproteinReceptors, Interleukin-6tocilizumab

Identifiers

PMID42440328
PMCPMC13366257

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