MOGAD vs. MS: No Silent Progression in MOGAD (Yet... Small Sample, Short Follow-up)

Overview

Paper Summary › Explain Like I'm Five › Conflicts of Interest › Identified Limitations › Rating Explanation › Good to know › Topic Hierarchy › File Information ›

Paper Summary

Paperzilla title

This study with limited sample size and follow-up duration suggests that MOGAD, unlike relapsing-remitting multiple sclerosis (RRMS), might not exhibit progression independent of relapse activity (PIRA). While RRMS patients experienced both clinical and cognitive worsening without new attacks, no PIRA was observed in the MOGAD group. However, the RRMS group also showed faster brain atrophy in specific regions and increased free water content in existing brain lesions compared to both MOGAD and healthy controls.

Explain Like I'm Five

In a study comparing MOGAD (a disease similar to MS) to MS, it was found that MS patients experience worsening disability even without new attacks, unlike MOGAD patients.

Possible Conflicts of Interest

This study was partially funded by Roche Pharma. Several authors reported receiving honoraria, research funding, travel grants, and/or consulting fees from various pharmaceutical companies, including Roche, Jansen, BMS, Novartis, Alexion, Amgen, Biogen, Merck, Sanofi, UCB, and Horizon Therapeutics.

Identified Limitations

Small Sample Size

The sample size is too small to draw definitive conclusions, especially for rare events like PIRA. The limited number of participants reduces the statistical power of the study.

Short Follow-up Duration

The follow-up duration is relatively short. Longer observation is necessary to assess the long-term progression of both diseases and confirm the absence of PIRA in MOGAD.

Lack of Correction for Multiple Comparisons

The authors didn't correct for multiple comparisons in their statistical analyses. This increases the risk of type I errors (false positives) and might lead to spurious findings.

Different Cognitive Assessment Tools

The use of different cognitive tests for MOGAD and MS (BRBNTs vs. BICAMS) introduces comparability issues. A standardized cognitive assessment tool would enable more direct comparisons.

Unequal Treatment Status

Most RRMS patients were on disease-modifying therapy, while most MOGAD patients were not. This difference in treatment could confound the results and underestimate the true differences between the diseases regarding PIRA.

Lack of Histopathological Validation for dMRI

The lack of histopathological validation for dMRI metrics limits the interpretation of the results. Further research is needed to establish the pathological specificity of these metrics in MOGAD.

Rating Explanation

This is a prospective comparative study investigating an important clinical question. However, several limitations, including the small sample size, short follow-up duration, and lack of correction for multiple comparisons, warrant a moderate rating. The potential conflicts of interest due to industry funding and relationships with pharmaceutical companies are also a concern.

Good to know

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Topic Hierarchy

Domain: Health Sciences

Field: Medicine

Subfield: Neurology

File Information

Original Title: Investigating the Presence of Neurodegeneration Independent of Relapses in MOGAD Compared to Relapsing-Remitting Multiple Sclerosis

Uploaded: August 21, 2025 at 02:23 PM

Privacy: Public