Neuromyelitis optica spectrum disorders: Emerging therapies

Araki, Mikiya; Yamamura, Takashi

doi:10.1111/cen3.12394

Cited by 10 publications

(7 citation statements)

References 87 publications

(84 reference statements)

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“…Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune disease of the central nervous system (CNS) that is characterized by inflammatory and demyelinating lesions in optic nerve, spinal cord brainstem and cerebrum, which can lead to progressive impairment of vision and motor functions [ 1 – 4 ]. The primary goal of NMOSD treatment is to reduce the risk of irreversible neurological impairment by preventing relapse and reducing the severity of attacks [ 5 , 6 ]. Recent research suggested that interleukin-6 (IL-6) has an important role in the immunopathogenesis of NMOSD [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

Satralizumab: First Approval

Heo

2020

Drugs

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Satralizumab (Enspryng ®), a humanized anti-interleukin-6 (IL-6) receptor monoclonal recycling antibody, has been developed by Chugai Pharmaceutical and Roche for the treatment of neuromyelitis optica spectrum disorder (NMOSD). In June 2020, based on positive results from two pivotal phase III trials, subcutaneous satralizumab received its first global approval in Canada for the treatment of NMOSD in adults and children aged ≥ 12 years who are aquaporin 4 water channel autoantibody (AQP4-IgG) seropositive. Satralizumab was subsequently approved in Japan, Switzerland and the USA. Satralizumab is under regulatory review in the EU, and is undergoing clinical development in several countries worldwide. This article summarizes the milestones in the development of satralizumab leading to this first approval for the treatment of NMOSD.

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Section: Introductionmentioning

confidence: 99%

Satralizumab: First Approval

Heo

2020

Drugs

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“…Phase I/II clinical trials were discontinued for various reasons. Sivelestat has already been approved in Japan and Korea for ARDS treatment [ 156 ].…”

Section: Emerging Therapeutic Approachesmentioning

confidence: 99%

Treatment and Relapse Prevention of Typical and Atypical Optic Neuritis

Saitakis

Chwalisz

2022

IJMS

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Optic neuritis (ON) is an inflammatory condition involving the optic nerve. Several important typical and atypical ON variants are now recognized. Typical ON has a more favorable prognosis; it can be idiopathic or represent an early manifestation of demyelinating diseases, mostly multiple sclerosis (MS). The atypical spectrum includes entities such as antibody-driven ON associated with neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody disease (MOGAD), chronic/relapsing inflammatory optic neuropathy (CRION), and sarcoidosis-associated ON. Appropriate and timely diagnosis is essential to rapidly decide on the appropriate treatment, maximize visual recovery, and minimize recurrences. This review paper aims at presenting the currently available state-of-the-art treatment strategies for typical and atypical ON, both in the acute phase and in the long-term. Moreover, emerging therapeutic approaches and novel steps in the direction of achieving remyelination are discussed.

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“… 74 Although phase I/II clinical trials were discontinued for various reasons, a granulocyte-targeting therapy remains a promising therapeutic approach. 75 …”

Section: Prevention Of Relapsesmentioning

confidence: 99%

Drug Treatment of Neuromyelitis Optica Spectrum Disorders: Out with the Old, in with the New?

Held

Klein

Berthele

2021

ITT

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Introduction: Neuromyelitis optica spectrum disorders (NMOSD) are rare neuroinflammatory demyelinating diseases of the CNS, mainly affecting optic nerves, spinal cord and brainstem regions. The diagnosis depends on clinical symptoms, MRI findings and the detection of autoantibodies against the water channel aquaporin 4 (AQP4-Ab). This autoantibody is particularly important for diagnostic sensitivity and specificity and further sets the course for major therapeutic decisions. Due to a relapsing course with the accumulation of disability, relapse prevention by immunotherapy is crucial in NMOSD. Until recently, disease-modifying agents specific to NMOSD were not available, and patients were treated with various immunosuppressive drugs and regimens-with variable success. Fortunately, since 2019, three new therapeutic antibodies have entered the market. Areas Covered: We aim to shortly summarise the pathogenesis and biological targets for acute and preventive therapy of adult NMOSD. We will focus on conventional immunotherapies and the recently approved novel biological drugs satralizumab, eculizumab and inebilizumab, and conclude with a brief outlook on future therapeutic approaches. Expert Opinion: Although satralizumab, eculizumab and inebilizumab are a breakthrough concerning short-term efficacy, important questions on their future use remain open. There is no data from head-to-head comparisons, and data on long-term safety and efficacy of the new medicines are pending. Whether any of the biologics are efficacious in AQP4-Ab negative NMOSD patients is not yet known-as is how they will succeed in non-responders to conventional immunotherapies. Further, (autoimmune) comorbidities, affordability, and market availability of drugs may be decisive factors for choosing treatments in the near future. We are fortunate to have these new drugs available now, but they will not immediately supersede established off-label drugs in this indication. It is still too early to definitively revise the treatment algorithms for NMOSD-although we are probably on the way.

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Neuromyelitis optica spectrum disorders: Emerging therapies

Cited by 10 publications

References 87 publications

Satralizumab: First Approval

Satralizumab: First Approval

Treatment and Relapse Prevention of Typical and Atypical Optic Neuritis

Drug Treatment of Neuromyelitis Optica Spectrum Disorders: Out with the Old, in with the New?

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