Emerging Biomarkers to Consider for NMOSD, Neuromyeltis Optica: Bruce Cree, MD, PhD, MAS, FAAN

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The clinical research director of the UCSF Multiple Sclerosis Center discussed the need for measures of progression in neuromyelitis optica and the next steps in treatment. [WATCH TIME: 4 minutes]

WATCH TIME: 4 minutes

"I don’t think we’re very far away. All of the components of technology are there. Now, it’s going to take somebody to champion this and move it forward. And so, the data we have from the clinical trial is extremely convincing."

FDA-approved treatment options for patients with neuromyelitis optica spectrum disorder (NMOSD) only began in 2019, as Alexion’s eculizumab (Soliris), a first-in-class complement inhibitor, became the first to gain greenlight. Following that, the FDA then approved inebilizumab (Uplizna; Horizon Therapeutics) 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 NMOSD who are aquaporin-4(AQP4)-positive.

At the 2022 European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress, October 26-28, in Amsterdam, Netherlands, additional post-hoc data from the phase 3 N-MOmentum (NCT02200770) study of inebilizumab was presented. Using absolute counts of CD20+ B-cells and CD27+ memory B-cells in the peripheral blood, plasma cell gene expression, and AQP4-immunoglobulin titers, investigators found significant increases in AQP4-IgG titer in the placebo group at the time of attack relative to baseline but not in those treated with inebilizumab (P = .76).

Study investigator Bruce Cree, MD, PhD, MAS, FAAN, sat down with NeurologyLive^® at ECTRIMS 2022 to discuss the need for measures that track disease progression in NMOSD, and the shift in focus similar to multiple sclerosis field. He also provided commentary on biomarkers such as glial fibrillary acidic protein and neurofilament light, and when clinicians can expect more complete, high-powered tools to enter clinics.

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