Work

A Challenging Case of MOG-Associated Optic Neuritis: The Role of IL-6 Inhibition in Refractory Disease

Year: 2025

Type: article

Abstract: We present a case of a 21-year-old woman diagnosed with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), characterized by recurrent optic neuritis and progressive vision loss. Despite multiple immunosuppressive therapies-including corticosteroids, intravenous immunoglobulin (IVIG), azathioprine, mycophenolate mofetil, and rituximab-the patient continued to experience disabling relapses, particularly during steroid tapering. Ongoing disease activity, combined with significant steroid-related side effects, prompted a trial of subcutaneous tocilizumab, an interleukin-6 (IL-6) receptor inhibitor. Following its introduction, the patient remained relapse-free, and her steroid dose was successfully reduced. This case highlights the complexity of managing refractory MOGAD and underscores the potential role of IL-6 inhibition in treatment-resistant cases. There are sparse reports about the use of subcutaneous tocilizumab (TCZ) in MOGAD, and this case contributes to the growing body of real-world evidence supporting its use. As no standardized treatment protocol currently exists, reporting such cases is vital for advancing future therapeutic strategies and guidelines.

Source: International Medical Case Reports Journal

DOI: 10.2147/imcrj.s563753

Authors: Hind Alnajashi, Mesedah Alnahdi

Institutions: King Abdulaziz University, King Abdul Aziz University Hospital, King Abdulaziz Hospital

Language: English

Topic: Multiple Sclerosis Research Studies

Subfield: Pathology and Forensic Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,320