National Consensus Guidance for the Diagnosis and Management of Adult Patients with Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease

Abstract

Background: The emergence of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), defined by the presence of antibodies against myelin oligodendrocyte glycoprotein (MOG), has prompted the need for standardized management approaches. Given the current absence of high-level evidence, we aimed to develop consensus-based guidance for the management of MOGAD.Methods: The Korean Society of Neuroimmunology established a task force comprising a panel of 13 experts, and the RAND/UCLA appropriateness methodology was adopted. Definitions were developed for core clinical manifestation, acute stage, relapse, and persistent MOG-IgG seropositivity. Based on extensive review of the literature, initial guidance statements on four key topics were developed. Two rounds of anonymous votes were conducted to achieve consensus on guidance statements, with modifications based on panel input.Results: Comprehensive guidance statements were developed covering MOG antibody assay and diagnosis, acute treatment, and long-term immunotherapy for MOGAD.Conclusion: This guidance is a national formal consensus of MOGAD experts intended to serve as a valuable guide for clinicians managing Korean adults with MOGAD.