Building a Greater Understanding for NMOSD Treatments, Neurodegeneration: John Chen, MD, PhD

WATCH TIME: 3 minutes

"It’s nice that we’ve got evidence-based medicine to show that these medications work. In terms of our choice, it depends on the patient. Some patients would rather have a treatment every 6 months, so they’d probably go with inebilizumab."

Neuromyelitis optica spectrum disorder (NMOSD) has seen immense progress in the past 2 decades, from the discovery of the aquaporin-4 (AQP4) antibody to the first of 3 FDA-approved therapies in 2019, with Alexion’s eculizumab (Soliris). The FDA then approved inebilizumab (Uplizna; Horizon) in June 2020 and satralizumab (Enspryng; Genentech) in August 2020. All 3 therapies, while different in mechanistic action, are indicated to treat only patients with AQP4-positive NMOSD.

Each of these medications demonstrated significant effects on relapses in patients with NMOSD; however, each attack is still considered potentially devastating. Additionally, the safety profiles of the FDA-approved medications are drastically different than previously used off-label therapies, which have been associated with risk of infections, particularly upper respiratory infections and urinary tract infections. John Chen, MD, PhD, a neuroophtalmologist at Mayo Clinic, believes a lot of prescribing methods with approved therapies for NMOSD comes down to patient preference and administration.

In an interview with NeurologyLive^®, Chen described the clinical lessons learned since the introduction of therapies to treat NMOSD, as well as the next steps in the management of the disease and the discussions around tackling neurodegeneration and remyelination. He spoke specifically about the ongoing research initiatives and the challenges with animal studies. Additionally, he mentioned the importance of treating optic neuritis and some of the other lingering symptoms.