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The following summarizes some of the highlights from Day 1 of the American Academy of Neurology annual meeting (AAN), Chicago, Illinois, April 18-22, 2026.
Impact of obesity on MS hospitalizations
GLP-1 agonists in MS
Ocrelizumab in pediatric-onset MS
Ofatumumab in MOGAD
New McDonald criteria more accurate for RIS
Improved longevity for MS patients in U.S.
CONGRESS HIGHLIGHTS – MONDAY EDITION
Impact of obesity on MS hospitalizations
A U.S. database analysis examined the impact of obesity on hospitalization for patients admitted for MS relapses for the period 2016-2022 (Sohaib et al. AAN 2026;P1.012). Overall, there were more than 158,000 relapse-related hospital admissions, of which 19% involved people with obesity. Obese patients were younger (mean age 44.8 years) and predominantly female (79.4%). Obesity was associated with a slightly longer length of hospital stay (mean 4.8 days vs. 4.6 days) and a costlier stay ($67,890 vs. $65,440). The in-hospital mortality rate and pattern of discharges were similar for the two groups.
GLP-1 agonists in MS
A retrospective study looked at lifestyle changes in 70 MS patients starting on a glucagon-like peptide (GLP)-1 agonist for diabetes or obesity (Heward et al. AAN 2026;P1.009). Mean age was 51 years, median EDSS score was 2.5, mean follow-up was 7.2 months. Physical activity increased 65% over the observation period, from 52.3 to 115.7 minutes/week. Patients reported improvements in anxiety, bowel/bladder dysfunction and sensory symptoms. There were also small improvements in pain, vision, spasticity and dizziness. No significant changes were seen with depression, cognition, walking or hand function.
A separate database study (N=339,092) examined whether GLP-1 agonists have immunomodulatory or neuroprotective effects in MS patients (Irfan et al. AAN 2026;P3.013). Four percent of the study population had been exposed to GLP-1 agonists. Treatment was associated with a lower rate of relapses requiring steroids (2.33% vs. 5.0%), less frequent demyelinating events (3.58% vs. 6.5%) and fewer episodes of optic neuritis (1.53% vs. 4.02%). Patients receiving GLP-1 agonists also showed fewer gait/mobility abnormalities (7.56% vs. 12.76%), less fatigue (8.3% vs. 14.2%) and a lower rate of depression (18.1% vs. 25.2%).
Ocrelizumab in pediatric-onset MS
The phase III OPERETTA study compared ocrelizumab 600 mg q24wk and fingolimod 0.5 mg/day in 187 pediatric-onset MS patients aged 10-17 years for at least 96 weeks (Banwell et al. AAN 2026;S40.005). At baseline, the mean number of T2 lesions was 57.4 and the mean number of Gd+ lesions was 2.4. Ocrelizumab was noninferior to fingolimod with respect to relapses (rate ratio 0.52) and superior in reducing the Gd+ lesion number (RR 0.13) at week 12. Ocrelizumab was generally well tolerated with no treatment withdrawals due to adverse events.
Ofatumumab in MOGAD
A small study compared the efficacy of two anti-CD20 agents, subcutaneous ofatumumab and IV rituximab, in 43 patients with myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) (Fan et al. AAN 2026;P8.008). There are no approved treatments in Canada for MOGAD but some clinicians may use anti-CD20 agents off-label. Overall, 81.2% of patients treated with ofatumumab were relapse-free over the median 19.5-month follow-up. A propensity-matched comparison found that the risk of a second attack was significantly lower with ofatumumab versus rituximab (hazard ratio 0.238).
New McDonald criteria more accurate for RIS
A new study compared the classification of radiologically-isolated syndrome (RIS) using the RIS 2023 diagnostic criteria (Lebrun-Frénay et al. Brain 2023;146:3431-3443) versus the revised 2024 McDonald criteria (Gunduz et al. AAN 2026;S40.003). Fewer patients met RIS criteria with McDonald 2024 (57.9% vs. 63.4%). The McDonald criteria were better at predicting early clinical conversion. Overall, 50% in the RIS 2023 cohort had their first clinical event after a median of 5.8 years compared to 4.1 years for the McDonald cohort. The sensitivity of McDonald 2024 criteria and the RIS 2023 criteria was similar (0.89 vs. 0.87), but the McDonald criteria had better specificity (0.53 vs. 0.45) and overall accuracy (0.62 vs. 0.56).
Improved longevity for MS patients in U.S.
An epidemiological study in the U.S. examined changes in the age at death for MS patients for the period 1999-2023 (Kennedy et al. AAN 2026;P11.005). Data were obtained from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiological Research (CDC-WONDER) records of mortality. Over the time period there were 145,547 deaths of MS patients, of which 67.8% were female. The mean age of death increased from 63.9 to 68.1 years for females, and from 62.5 to 66.2 years for males.
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