Managing NMOSD Disease Progression Through Healthy Habits and Holistic Care: Tammy Smith, MD, PhD

WATCH TIME: 3 minutes

"Creating a culture in your clinic where you ask about broader quality-of-life issues is fundamental for truly comprehensive care."

In neuromyelitis optica spectrum disorder (NMOSD), an inflammatory disorder of the central nervous system, relapse prevention has always been the main goal, as recurrent attacks are the key driver of neurological impairment. The most common approach to acute relapse management has been immediate initiation of high-dose corticosteroids, with a slow taper to ameliorate neurological impairment. Unfortunately, for a number of patients living with the disease, corticosteroids are not sufficient, and another immunotherapy is often needed.

The discovery of aquaporin-4 (AQP4), an antibody directly linked to NMOSD, has opened the door for several new treatments in recent years, each with varying mechanisms of action. While these drugs have significantly better efficacy on relapses, there are still several other notable symptoms that impact patients’ quality of life, including visual disturbances, spinal cord symptoms, fatigue and pain, and other neurological issues such as muscle spasms, stiffness, or tremors. A truly comprehensive and effective treatment strategy will address not only relapses, but the rest of the disease, says Tammy Smith, MD, PhD.

Smith, an assistant professor in the neurology department at the University of Utah in Salt Lake City, recently sat down with NeurologyLive® to discuss best strategies in maintaining a high quality of life for patients with NMOSD. She highlighted the need for clinicians to discuss often-overlooked issues such as fatigue, mood disorders, chronic pain, and sexual dysfunction with patients to ensure holistic care. Additionally, she emphasized the neurologist’s role in reinforcing healthy lifestyle habits, such as smoking cessation, regular exercise, and a healthy diet, while also encouraging routine screenings and collaboration with primary care providers for comprehensive care.