Treatment of neuromyelitis optica: Review and recommendations

Journal article

Neuromyelitis optica (NMO) is an autoimmune demyelinating disease preferentially targeting the optic nerves and spinal cord. Once regarded as a variant of multiple sclerosis (MS), NMO is now recognized to be a different disease with unique pathology and immunopathogenesis that does not respond to traditional MS immunomodulators such as interferons. Preventive therapy in NMO has focused on a range of immunosuppressive medications, none of which have been validated in a rigorous randomized trial. However, multiple retrospective and a few recent prospective studies have provided evidence for the use of six medications for the prevention of NMO exacerbations: azathioprine, rituximab, mycophenolate mofetil, prednisone, methotrexate and mitoxantrone. This review provides a comprehensive analysis of each of these medications in NMO and concludes with a set of recommended consensus practices. Copyright 2012 Elsevier B.V.

Authors: Kimbrough, D; Fujihara, K; Jacob, A; Lana-Peixoto, M; Isabel Leite, M

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Elsevier
• Journal: Multiple Sclerosis and Related Disorders
• Volume: 1
• Issue: 4
• Pages: 180-187
• Publication date: 2012-10-01
• DOI: 10.1016/j.msard.2012.06.002
• ISSN: 2211-0348
• Language: English
• Keywords: Aquaporin 4; Optic neuritis; Transverse myelitis; Immunosuppression; Neuromyelitis optica; NMO treatment