From the Research
Neuromyelitis optica spectrum disorder (NMOSD) should be treated with rituximab as the first-line therapy for preventing relapses, as it has been shown to be superior to azathioprine and mycophenolate mofetil in reducing relapse rates and improving disability, as demonstrated in a systematic review and meta-analysis 1. The treatment of NMOSD typically involves acute management of attacks with high-dose intravenous corticosteroids (methylprednisolone 1000mg daily for 3-5 days) and plasma exchange for severe attacks, as supported by recent studies 2, 3. Some key points to consider in the treatment of NMOSD include:
- Early diagnosis and treatment are crucial to prevent permanent neurological damage, as NMOSD attacks tend to be more severe and less likely to fully resolve compared to multiple sclerosis.
- Long-term management focuses on preventing relapses with immunosuppressive medications, with rituximab being a preferred option due to its efficacy and safety profile, as shown in a comparative analysis of treatment outcomes 1.
- Regular monitoring with MRI scans, visual testing, and neurological examinations is essential to assess disease activity and treatment response, as highlighted in recent reviews on the treatment of NMOSD 4, 3.
- Newer targeted therapies like eculizumab, inebilizumab, or satralizumab may also be considered for the treatment of NMOSD, as discussed in recent studies on advances in the long-term treatment of the disease 4. The most recent and highest quality study on the treatment of NMOSD, a systematic review and meta-analysis published in 2022, supports the use of rituximab as the first-line therapy for preventing relapses, due to its superior efficacy and safety profile compared to other immunosuppressive medications 1.