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

★

☆

SHARE

Overview

Paper Summary

Conflicts of Interest

Identified Weaknesses

Rating Explanation

Good to know

Topic Hierarchy

File Information

Paper Summary

Paperzilla title

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

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.

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 Weaknesses

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

This is our free standard analysis. Paperzilla Pro fact-checks every citation, researches author backgrounds and funding sources, and uses advanced AI reasoning for more thorough insights.

Explore Pro →