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Neurotherapeutics
Published in: Neurotherapeutics 3/2022

01-04-2022 | Rituximab | Review

Monoclonal Antibody Therapies Beyond Complement for NMOSD and MOGAD

Authors: Vyanka Redenbaugh, Eoin P. Flanagan

Published in: Neurotherapeutics | Issue 3/2022

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Abstract

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.
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Metadata
Title
Monoclonal Antibody Therapies Beyond Complement for NMOSD and MOGAD
Authors
Vyanka Redenbaugh
Eoin P. Flanagan
Publication date
01-04-2022
Publisher
Springer International Publishing
Published in
Neurotherapeutics / Issue 3/2022
Print ISSN: 1933-7213
Electronic ISSN: 1878-7479
DOI
https://doi.org/10.1007/s13311-022-01206-x

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