Monoclonal Antibody Therapies Beyond Complement for NMOSD and MOGAD.
Vyanka RedenbaughEoin Patrick FlanaganPublished in: Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics (2022)
Aquaporin-4 (AQP4)-IgG seropositive neuromyelitis optica spectrum disorders (AQP4-IgG seropositive NMOSD) and myelin oligodendrocyte glycoprotein (MOG)-IgG-associated disease (MOGAD) are inflammatory demyelinating disorders distinct from each other and from multiple sclerosis (MS).While anti-CD20 treatments can be used to treat MS and AQP4-IgG seropositive NMOSD, some MS medications are ineffective or could exacerbate AQP4-IgG seropositive NMOSD including beta-interferons, natalizumab, and fingolimod. AQP4-IgG seropositive NMOSD has a relapsing course in most cases, and preventative maintenance treatments should be started after the initial attack. Rituximab, eculizumab, inebilizumab, and satralizumab all have class 1 evidence for use in AQP4-IgG seropositive NMOSD, and the latter three have been approved by the US Food and Drug Administration (FDA). MOGAD is much more likely to be monophasic than AQP4-IgG seropositive NMOSD, and preventative therapy is usually reserved for those who have had a disease relapse. There is a lack of any class 1 evidence for MOGAD preventative treatment. Observational benefit has been suggested from oral immunosuppressants, intravenous immunoglobulin (IVIg), rituximab, and tocilizumab. Randomized placebo-controlled trials are urgently needed in this area.
Keyphrases
- multiple sclerosis
- white matter
- mass spectrometry
- drug administration
- monoclonal antibody
- double blind
- ms ms
- diffuse large b cell lymphoma
- rheumatoid arthritis
- squamous cell carcinoma
- stem cells
- open label
- systemic lupus erythematosus
- radiation therapy
- mesenchymal stem cells
- chronic lymphocytic leukemia
- study protocol
- low dose
- bone marrow
- locally advanced
- phase ii study