Efficacy and safety of interleukin-6 receptor inhibitors in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD): A systematic review and meta-analysis.

Background: Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) can follow a relapsing course, yet evidence for effective maintenance therapy remains limited. Interleukin-6 receptor (IL-6R) inhibition has emerged as a potential relapse-prevention strategy. Objectives: To evaluate the efficacy and safety of tocilizumab and satralizumab in patients with MOGAD. Design: Systematic review and random-effects proportional meta-analysis conducted in accordance with PRISMA 2020. Data Sources and Methods: PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar were searched from inception through 14 July 2026. Eligible studies reported outcomes in patients with MOGAD treated with an IL-6R inhibitor. The primary outcome was the proportion remaining relapse-free during treatment. Secondary outcomes included annualized relapse rate (ARR), disability, MRI activity, and infectious adverse events. Proportions were pooled using DerSimonian-Laird random-effects models, and study quality was assessed using the Newcastle-Ottawa Scale. Results: Six observational studies comprising 182 treated patients were included. The pooled relapse-free proportion was Conclusion: IL-6R inhibition was associated with substantial relapse control in selected patients with MOGAD, supporting its potential role as a maintenance therapy. However, the evidence remains limited by observational designs, heterogeneous treatment regimens and follow-up, concomitant therapies, and the influence of one large cohort.