A Case-Based Overview of Treatment Strategies for Relapse Prevention in MOGAD: Smathorn Thakolwiboon, MD

A session presented at the recently concluded2025 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, held May 28-31, 2025, in Phoenix, Arizona, featured expert-led case presentations that highlighted diagnostic and therapeutic challenges in neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Chaired by Eoin P. Flanagan MD, MBBCh, the session began with his overview and illustrative cases focused on MOGAD diagnosis, followed by insight offered by Brian G. Weinshenker, MD, into NMOSD diagnostic approaches.

After a brief intermission, Smathorn Thakolwiboon, MD, presented a case-based discussion on treatment strategies for MOGAD, emphasizing steroid tapering and relapse prevention. Then Shailee Shah, MD, concluded the session with clinical cases demonstrating treatment considerations for NMOSD, offering a comparative perspective across both disorders. Overall, the session provided attendees with practical, evidence-informed guidance to improve diagnosis and long-term care in patients living with these antibody-mediated demyelinating diseases.

Prior to the session at the meeting, Thakolwiboon, assistant professor of neurology at Mayo Clinic College of Medicine and Science, had a conversation with NeurologyLive^® to share a comprehensive case of a woman aged in her 70s diagnosed with MOGAD. The discussion followed her clinical course from initial presentation with optic neuritis to the development of relapsing disease. Key management points noted by Thakolwiboon included early initiation of steroids, the risks of rapid tapering, the role of adjunctive therapies, and evolving approaches to relapse prevention. Ongoing and future clinical trials in immunotherapy were also discussed, alongside considerations for treatment discontinuation and optimal steroid tapering strategies.