Following an acute attack, 55.8% (29/52) of respondents typically continue corticosteroids for ≥ 3 months though less commonly when treating children. 45.5% (5/11) of paediatric neurologists use IV immunoglobulin (IVIg) in preference to PE. If recovery is incomplete, 71.2% (37/52) proceed next to plasma exchange (PE). All treat acute attacks with high dose corticosteroids. Results: Fifty-two responses were received (response rate 60.5%) from 86 invited experts, comprising adult (78.8%, 41/52) and paediatric (21.2%, 11/52) neurologists in 22 countries. Method: Neurologists worldwide with expertise in treating MOGAD participated in an online survey (February–April 2019). Objective: To survey the current global clinical practice of clinicians treating MOGAD. Conclusion: Current treatment of MOGAD is highly variable, indicating a need for consensus-based treatment guidelines, while awaiting definitive clinical trials.Ībstract = "Introduction: While monophasic and relapsing forms of myelin oligodendrocyte glycoprotein antibody associated disorders (MOGAD) are increasingly diagnosed world-wide, consensus on management is yet to be developed. Regardless of monitoring results, 25.0% (13/52) would not stop MT. Treatment response is monitored by MRI (53.8% 28/52), optical coherence tomography (23.1% 12/52) and MOG antibody titres (36.5% 19/52). In children, IVIg is the preferred first line MT (54.5% 6/11). Commonly used first line MTs in adults are azathioprine (30.8%, 16/52), mycophenolate mofetil (25.0%, 13/52) and rituximab (17.3%, 9/52). Repeat MOG antibody status is used by 52.9% (27/51) to help decide on MT initiation. After an index event, 60% (31/51) usually start steroid-sparing maintenance therapy (MT) after ≥ 2 attacks 92.3% (48/52) would start MT. Introduction: While monophasic and relapsing forms of myelin oligodendrocyte glycoprotein antibody associated disorders (MOGAD) are increasingly diagnosed world-wide, consensus on management is yet to be developed. Guy's and St Thomas' NHS Foundation Trust.University of Colorado Denver Anschutz Medical Campus.The University of Texas Southwestern Medical Center.Pontifical Catholic University of Rio Grande do Sul School of Medicine.Tohoku Medical and Pharmaceutical University.Research Institute and Hospital of National Cancer Center.Behandlungszentrum Kempfenhausen für Multiple Sklerose Kranke gGmbH.Erasmus University Medical Center Rotterdam.UCL Queen Square Institute of Neurology.
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