This study focuses on myelin oligodendrocytes glycoprotein antibody associated diseases (MOGAD), a condition where the immune system attacks the protective covering of nerve cells. The study will evaluate two treatment approaches in children: immediate treatment starting with the first attack versus delayed treatment starting with the second attack. The medications being tested are azathioprine, taken as tablets, and rituximab, given through an intravenous infusion. During the study, patients may also receive other medications including methylprednisolone, prednisone, and prednisolone to help manage symptoms.

The purpose of this research is to compare how well immediate versus delayed treatment works in preventing disease relapses over a 24-month period. The study will measure how often relapses occur in children who start treatment right away compared to those who start treatment after experiencing a second attack of the disease. This information will help determine the best timing for starting treatment in children with this condition.

Throughout the study period, participants will receive either azathioprine tablets taken by mouth or rituximab given through an intravenous line. The treatment will continue for 24 months, during which doctors will monitor the participants’ response to the medication and track any new episodes of the disease. Various tests will be performed to assess how well the treatments are working and to monitor the participants’ health status.