The manufacturer of Imuran cautions about a risk of PML with Imuran as well, but the incidence of PML on Imuran is not documented.
The known rate of incidence of PML if on Rituxan is estimated at 1 in 25,000 and the rate in CellCept is estimated at 1 in 6,000 based on data from use of these medications for immunosuppression for other purposes. It is important to know that exposure to these medications in MOG antibody disease has not led to a known case of PML. Although it can be treated, it is very devastating and sometimes fatal. In someone who is immunosuppressed, this virus can escape the kidney, cross the blood-brain barrier, and enter the brain, causing profound inflammation. PML is an infection caused by the reactivation of a virus, called the JC virus, which lives in the kidney. There is also the risk with any of these medications of the development of a rare brain infection called progressive multifocal leukoencephalopathy, or PML. Good hygiene and hand washing are important if on immunosuppressants, as is having a good urologist if at risk for UTIs. Some patients presenting with optic neuritis or transverse myelitis who also test positive for the MOG antibody may start treatment after the initial event if the attack was severe and the individual does not want to risk a relapse.Īll of these medications carry a risk of infections, particularly upper respiratory infections and urinary tract infections (UTIs). Some studies from the United Kingdom have supported the use of IVIG to prevent relapses. The primary therapies used in the US are mycophenolate mofetil (CellCept), rituximab (Rituxan), azathioprine (Imuran), and repeated IVIG infusions or subcutaneous immunoglobulin. There are no FDA-approved medications for maintenance in MOG antibody disease, so anything prescribed is done off-label. Those with MOG antibody disease should consider ongoing treatment with medications that suppress the immune system. 4,13 In contrast, two other studies showed that the retinal neuro-axonal damage found after an acute attack of optic neuritis was as severe among anti-MOG positive individuals as individuals with AQP-4 positive NMOSD.
#Mog optic neuritis full#
4,13 They found that one third of patients with optic neuritis and around half of patients with spinal cord inflammation made a full recovery. 4,8Ī cohort study from 2016 found that 80% of those in the cohort had a multiphasic disease and an annualized relapse rate (AAR) of 0.9. Initially, the presence of anti-MOG was thought to be associated with fewer relapses and better outcomes than those with AQP-4 positive NMOSD, 5,8 but studies with longer follow-up times indicate higher relapse rates than previously reported.
0 kommentar(er)
