Validation of the MOG-AR Score: A Retrospective Multicenter Study

OBJECTIVES: A score evaluating age at onset, sex, clinical phenotype, and treatment received (MOG-AR) has been proposed to identify MOGAD patients at high relapse risk. The aim of this study was to validate the MOG-AR score in a multicenter cohort and to assess other variables potentially associated with relapses.

METHODS: MOGAD patients were retrospectively enrolled from 24 centers. The MOG-AR score was applied and 4 categories of relapse risk were identified (grade I: lowest risk; grade IV: highest risk), accordingly. The association of MOG-AR score and additional variables with a relapsing course were then explored.

RESULTS: Of 190 included patients, the median age at onset was 37 [IQR 23-51] years and 107 (56%) were female. A total of 78 patients (41%) experienced a relapse during a median of 43.6 months [24.8-75.4]. Using the proposed cutoff of 9, the MOG-AR score had a sensitivity of 53.9% [95% CI 55.6-73.9] and a specificity of 65.18% [95% CI 55.60-73.93]; area under the curve: 0.64 (95% CI 0.57-0.72). Among additional investigated factors, only immunosuppressive treatment after the presenting MOGAD attack was associated with a lower relapse risk.

DISCUSSION: MOG-AR score failed to accurately predict a relapsing disease course. Only immunosuppressive treatment after the first event was significantly associated with a lower relapse risk.