{
  "abstract": "Background Detection of immunoglobulin G targeting myelin oligodendrocyte glycoprotein (MOG-IgG) is the mainstay of laboratory diagnosis of MOG antibody-associated disease. Laboratory biomarkers have the potential to predict disease course and activity, thus informing prompt therapeutic decisions to minimise relapse-associated disability accrual.Methods This systematic review with meta-analysis was registered in PROSPERO (CRD42024554429). MEDLINE, Embase and Scopus databases were searched. Random-effects or mixed-effects modelling was performed and OR or HR with 95% CIs reported.Results 106 studies with ≥1710 individuals were included. A relapsing course was associated with persistent seropositivity on serial samples collected ≥3 months apart (OR 2.7 (95% CI 1.8 to 4.0), p<0.0001), lower likelihood of seroreversion to negative status (HR 0.19 (95% CI 0.14 to 0.26), p<0.0001) and delayed seroreversion compared with monophasic participants (median 19 years vs 2.5 years, p<0.0001). Acute disseminated encephalomyelitis was associated with a non-relapsing course (OR 0.049 (95% CI 0.0029 to 0.84), p=0.037). Serum MOG-IgG titre—negative, low positive or clear positive—discriminated disease state: attack was associated with clear positive titre (OR 3.6 (95% CI 2.6 to 5.0), p<0.0001), but not negative titre (OR 0.073 (95% CI 0.028 to 0.19), p<0.0001). Cerebrospinal fluid (CSF) leucocytosis (≥5 cells/µL) was associated with attack (OR 3.1 (95% CI 1.7 to 5.9), p=0.0004). Neither serum glial fibrillary acidic protein nor neurofilament light chain correlated with disease activity. Novel biomarkers of disease course and activity have also been assessed qualitatively.Conclusions MOG-IgG serostatus and titre and CSF leucocytosis are biomarkers of disease course and activity. The findings provide rationale for serial serum MOG-IgG testing at an interval of 3–6 months in the first 12 months of disease to assist in relapse risk stratification.PROSPERO registration number CRD42024554429.",
  "authors": [
    {
      "affiliations": [
        "Kids Neuroscience Centre, Kids Research at the Children’s Hospital at Westmead, Sydney, NSW, Australia",
        "Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia"
      ],
      "name": "Jane Andersen"
    },
    {
      "affiliations": [
        "Kids Neuroscience Centre, Kids Research at the Children’s Hospital at Westmead, Sydney, NSW, Australia",
        "Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia"
      ],
      "name": "Benjamin Peter Trewin"
    },
    {
      "affiliations": [
        "Kids Neuroscience Centre, Kids Research at the Children’s Hospital at Westmead, Sydney, NSW, Australia",
        "Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia",
        "Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia"
      ],
      "name": "Russell C Dale"
    },
    {
      "affiliations": [
        "Kids Neuroscience Centre, Kids Research at the Children’s Hospital at Westmead, Sydney, NSW, Australia",
        "Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia",
        "Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia",
        "Department of Neurology, Concord Hospital, Concord, NSW, Australia"
      ],
      "name": "Sudarshini Ramanathan"
    },
    {
      "affiliations": [
        "Kids Neuroscience Centre, Kids Research at the Children’s Hospital at Westmead, Sydney, NSW, Australia",
        "Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia",
        "Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia"
      ],
      "name": "Fabienne Brilot"
    }
  ],
  "title": "Biomarkers to predict relapse in myelin oligodendrocyte glycoprotein antibody-associated disease: a systematic review and meta-analysis",
  "uid": "3c11a580-63b5-5ec0-b421-79756e50245a"
}