Evolution of NMOSD Research and Implications for Other Autoimmune Diseases: Michael Levy, MD, PhD

WATCH TIME: 5 minutes

"Now that we have approved therapies, anything in the future will be compared to something that's already effective. That would mitigate the risk of participating in future clinical trials.”

Besides the 3 FDA approved medications——eculizumab (Soliris; Alexion), inebilizumab (Uplizna; Horizon Therapeutics), and satralizumab (Enspryng; Genentech), there are other approaches for treatment of patients with neuromyelitis optica spectrum disorder (NMOSD). One other therapeutic approach is Scrambler therapy which is an effective, feasible, and safe intervention for central neuropathic pain in patients with NMOSD, according to recent research.¹

In a previous published study in Neurology by senior author Michael Levy, MD, PhD, and colleagues, Scrambler therapy was investigated in a cohort of 22 patients to explore the effects on co-occurring symptoms in NMOSD. The randomized single-blind, sham-controlled trial (NCT03452176) had patients be on Scrambler therapy for 10 consecutive weekdays where they were assessed on pain severity, pain interference, anxiety, depression, and sleep disturbance.

In the trial, the median baseline numeric rating scale pain (NRS) score decreased from 5.0 to 1.5 after 10 days of treatment with Scrambler therapy, whereas in the sham arm, the median NRS score did not significantly decrease. Notably in the treatment arm, depression was also reduced, and anxiety decreased in a subset of patients who responded to treatment.

In a recent interview, Michael Levy, MD, PhD, sat down with NeurologyLive® to discuss the nonpharmacological approaches he would recommend to patients with the disease, including Scrambler therapy. Levy, associate professor at Harvard Medical School, also talked about the importance of patient-centered research in advancing the field and treatment approaches. In addition, he mentioned some of the challenges in recruiting patients with NMOSD for clinical trials as well as why he thinks there should be more generated awareness from ongoing research.

REFERENCES
1. Mealy MA, Kozachik SL, Cook LJ, et al. Scrambler therapy improves pain in neuromyelitis optica: A randomized controlled trial. Neurology. 2020;94(18):e1900-e1907. doi:10.1212/WNL.0000000000009370