Real-World Effectiveness and Safety of Monoclonal Antibodies in NMOSD: Amy Kunchok, MD, PhD

WATCH TIME: 4 minutes

"Our study replicates trial findings, offering reassurance to patients with NMOSD that these treatments provide effective disease control with no serious adverse events in the real world."

Previous research from clinical trials has described the efficacy of the novel monoclonal antibodies (MAbs) in patients with aquaporin 4 (AQP4)-immunoglobulin G (IgG)-positive neuromyelitis optica spectrum disorder (NMOSD),such as eculizumab (Soliris; Alexion), satralizumab (Enspryng; Genentech), and inebilizumab (Uplizna; Amgen); however, there is a lack of literature on real-world experience with these therapies. Recently, though, a real-world study undertaken by senior author Amy Kunchok, MD, PhD, and colleagues, showed strong efficacy and tolerability of nMAbs in treating AQP4-IgG+ NMOSD compared with rituximab.¹ Although these results support the efficacy and tolerability of approved nMAb’s to treat AQP4-IgG+ NMOSD, the authors recommend further research regarding long-term treatment outcomes.

Presented at the 2024 Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum, February 29 to March 2, by Kunchok,88 patients with AQP4-IgG+ NMOSD were included, and treatments included were rituximab (n = 69), inebilizumab (n = 9), eculizumab (n = 5), and satralizumab (n = 5). The median age was 58, without difference between rituximab and novel MAbs (P = 0.058). Among the novel MAbs group (n = 19), 84% (n = 16) of patients received prior conventional immunosuppressive therapies, and 16% were treatment–naïve. The authors noted that the main reason reported for switching treatment to novel MAbs was clinical relapse (75%).

Kunchok, staff neurologist at the Mellen Center for Multiple Sclerosis at Cleveland Clinic, recently sat down with NeurologyLive® at the forum to further discuss how the study evaluated the efficacy and safety of novel monoclonal antibodies in patients with NMOSD. She also talked about the reason why it is essential to assess the real-world data beyond the existing randomized controlled trials. Additionally, Kunchok spoke about the key implications for patients with NMOSD based on the study's findings.

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REFERENCES
1. Javed Z, Du M, J. Cohen, et al. Real World Efficacy and Tolerability of the Novel Monoclonal Antibodies as Compared to Rituximab for Neuromyelitis Optica Spectrum Disorder. Presented at ACTRIMS Forum 2024; February 29 to March 2; West Palm Beach, Florida. P326.